I never thought I would have a condition that was investigated on a TLC Discovery series called Strange Sex. In fact, I hadn’t even heard of vaginismus before I was finally diagnosed with the disorder in 2013 – after countless failed attempts at using tampons, and being told repeatedly by friends, family, and doctors that I “just needed to relax.”
In 2002, Susanna Kaysen, author of international bestseller Girl, Interrupted, released a memoir called The Camera My Mother Gave Me, which chronicles her struggle with vaginal pain. Almost a decade later, TLC Discovery aired the documentary about vaginismus. In her recently-published collection of autobiographical essays, Not That Kind of Girl, Lena Dunham discusses her fear of “chronic vaginal pain” and her past experience with vulvodynia. In a Cosmo blog article, titled “My Body Wouldn’t Let Me Have Sex,” author Savannah Grady openly describes her experience with vaginismus after she was raped at a party in 2006.
The topic of vaginismus is not totally absent in mainstream media, nor is the disorder particularly rare; according to the Society of Obstetricians and Gynaocologists of Canada, many individuals “will experience mild degrees of it throughout their lives.” Still, vaginismus and other vaginal pain disorders continue to be delegitimized, stigmatized, and overlooked altogether in public discussion of sexual health, while Viagra is advertised on primetime television.
In honor of the many individuals like myself who have vaginismus, I’ve decided to shed some light on the sexual disorder that society neglects to talk about.
What is vaginismus?
Vaginismus is a sexual dysfunction that refers to the involuntary tightening of the pelvic floor muscles in response to something being inserted in the vagina, making the insertion of tampons or vaginal sex excruciatingly painful or physically impossible altogether. I have primary, or lifelong vaginismus, which means that I’ve probably always had the condition. Secondary vaginismus refers to vaginismus that is developed after a period of pain-free intercourse, and usually occurs as a result of some kind of pelvic trauma, like childbirth. Situational vaginismus is a case of vaginismus that occurs only in certain situations; for instance, a person may easily be able to use tampons and undergo gyneacological exams, but is unable to have vaginal sex. Like the impulse to blink when something flashes before your eye, vaginismus is the vagina’s defense mechanism against possible pain. Unlike blinking, however, vaginismus only causes more pain, and is typically unwanted by the person who has the disorder.
What causes vaginismus?
Vaginismus can be caused by any number of physical or psychological factors. The disorder has been linked to past sexual abuse, phobias of illness or pregnancy, partner issues, and strict, religious upbringings. It has also been associated with medical conditions such as urinary tract infections and cancer, childbirth, menopause and hormonal changes, past surgery, and the usage of certain medications. However, vaginismus can be developed at any time, seemingly for no reason at all. I still do not know why I have vaginismus, though I suspect it might partly be attributed to anxiety.
What are the physical and emotional consequences of vaginismus?
If I wanted to, I could leave my vaginismus untreated and remain perfectly healthy. Unless penetration is forceably attempted, vaginismus generally has no physical consequences to the person who has it. However, because many individuals with vaginismus cannot undergo PAP screenings or other internal gynaecological exams, they naturally bear a higher risk of leaving signs cancer and other illnesses undetected than those who do not have vaginismus.
For many, the psychological impact of vaginismus can be even more agonizing than the physical pain. The stigma of “virginity,” combined with the lacking mention of vaginismus in public dialogue, society’s insistence that “men need sex,” and the social pressure on women to have children by a certain age, can all contribute to a dramatic decrease in the person’s self-esteem. As a result, some individuals with vaginismus may develop depression, or anxiety about sex. For many, the inability to have sex, or fear of sex, can lead to the repeated downfall of relationships; others resist dating altogether to avoid later disappointment.
Having vaginismus can be frustrating, alienating, and embarrassing. Overcoming vaginismus may be even more challenging for trans*, agender or genderfluid individuals, as the vaginismus programs and support groups that do exist only address the needs of cis women. What’s more, treating the disorder might be near to impossible for those with low income, as effective treatment can be costly and requires some medical coverage.
Can vaginismus be cured?
Fortunately, vaginismus can be “cured,” though individuals with primary vaginismus may experience some level of discomfort during sex for the rest of their lives. The key to overcoming vaginismus is training your body to relax the pelvic floor muscles that typically tighten upon attempted penetration. This can be achieved through pelvic floor therapy, vaginal dilators, and supplementary aids such as lubricants and pain medications. For some, psychological counselling and even sex therapy might help. The appropriate treatment, and length of treatment, differs from person to person; that said, I speak from experience when I say that the process inevitably requires some time, energy, and money.
What should I do if I think I have vaginismus?
If you think you might have vaginismus, you should see a doctor before attempting any kind of treatment. If you are 21 or under, you can visit a youth clinic, which deal with sexual health issues within a supportive, sex-positive environment. Many youth clinics do not charge for initial consultations. To find a youth clinic in your area, go to Vancouver Coastal Health’s site (for Vancouver and Richmond residents) or Fraser Health’s site (for residents of Surrey, Burnaby, Langley, New West, and Abbotsford).
Most general practitioners will refer you to a gyneocologist. Due to the high demand and low number of gyneocologists in British Columbia, scheduling an appointment can take several months to a year. In the meantime, you may want to ask your doctor about using a vaginal dilator set, which you can order online from Laurel Pharmacy, no prescription needed. If you suspect that your vaginismus may be the result of a traumatic event or a phobia, you can also request to be referred to a counselor for emotional support.
If you are a full-time student, you may be eligible to access counselling and sexual health services for free or a reduced rate through your SFSS health plan. It may be a good idea to research SFU’s internal health services and the extent of your medical coverage before even booking an appointment with a doctor.
For accessible and anonymous support, online platforms like Reddit and Tumblr have surprisingly large communities of individuals with vaginismus (though these sites should only be used to exchange words of encouragement – always consult and trust your doctor first!).
Treatments and therapy aside, I have found that the most important, and most challenging step to dealing with vaginismus is adjusting my own perspective. While an optimistic mindset won’t “cure” my vaginismus, I can’t help change the narrative of vaginal pain and sexual dysfunction if I continue being ashamed of my disorder. A person’s inability to have sex, get pregnant, use a tampon, or have a PAP smear does not interfere with their femininity, sexuality, or identity as a woman. Raising awareness about vaginismus could not only make treatment more widely available and affordable, but it could help eliminate the stigma surrounding vaginal pain disorders in general.
For more information on vaginismus and vaginal pain disorders, you can visit sogc.org.