Coping With Vaginismus
“The first time I tried to have sex, I thought, “oh, it might hurt a little—not that it’d be impossible”, says Audrey, a 23-year-old Chicago woman. “You know how you brace yourself for when a dentist is coming at you? It felt like I was bracing myself for something I wasn’t allowing to happen.”
Though Audrey didn’t know it at the time, she was suffering from a condition called vaginismus. Its name gives little hint to what actually was happening to Audrey—the muscles around the vagina contract, making it painful, if not impossible, for penetration to occur. While it doesn’t mean that other forms of sex aren’t fun, vaginal intercourse is definitely off the table until the problem gets resolved. As Audrey put it, “Your instincts have the power to push the brakes, whether you want to or not.”
This is not some obscure sexual issue—according to vaginismus.com, the condition is the main cause of unconsummated sexual relationships. It interferes with the vagina’s basic role, and depending on the study you consult, 12%-17% of women seeking sex therapy do so for vaginismus. But that number might be as high as 47%, amazingly high for a problem no one seems to have heard about. Audrey, in fact, only heard about vaginismus because a close friend with a severe case started speaking and writing publicly about it.
“At first, I thought it was normal, that I was nervous and in a few more tries I’d be fine,” said Audrey. “It was about a month later that I realized there was a problem.” The fascinating thing about vaginismus is that while the physical cause is obvious—muscles refusing to unclench—why those muscles are clenching in the first place can be harder to determine. It can still be physical—inflammation, infections and surgeries can lead to those muscle spasms. But the primary causes of vaginismus are, in a sense, in your head. Sexual abuse, trauma, and a fear or belief that sex is wrong often coincide with the experience of vaginismus.
For Audrey, growing up in a conservative Christian environment definitely contributed to her eventual condition. None of her friends had lost their virginity, and it took her until college to realize that people could and did have sex. And because of her shame, she decided she wouldn’t deal with this problem she had. She wouldn’t go to a gynecologist. Even after she heard about her friend who’d had vaginismus for three years, so what? She wasn’t dying. “Psychologically, I didn’t want to know that I had a serious problem. I was never good at sports, and now it felt like, “sex is another sport that I’m not good at.”
While a gynecologist can heighten fears—after all, vaginismus can be so severe that doctors can’t even get a speculum in for an inspection—they’re also key to solving it. They can prescribe solutions such as pelvic therapy, special dilators to stretch the muscles, and muscle relaxants such as Botox. But still, much of the work is mental—cognitive behavior therapy is another treatment option.
Sometimes even the simple assurance that the problem exists and is treatable helps. Five days after a visit she’d been putting off for years, Audrey lost her virginity. “I think hearing from a doctor that you’re not gonna die helped me. I’d been hearing my whole life from authority figures that sex was wrong, but here was this authority figure saying something different.”
As you might expect, partners can have a huge effect on a woman’s vaginismus journey. Audrey experienced both supportive and impatient partners. Of her first boyfriend, she says, “It demoralized us both. He didn’t think I found him attractive, and he became frustrated and selfish. I don’t think it ever dawned on him how much sex could hurt me, or that he wasn’t entirely convinced he was hurting me. He never said, but sometimes I think he wished I’d just suck it up.”
Her next boyfriend demonstrates all the fantastic things a partner can do for someone with vaginismus. “When I told him, he knew of the condition. He wanted to have sex with me, but he wanted me to go to a gynecologist on my own time, and to make it more for me than him. He actually studied vaginismus more than I did, and even pointed out which muscles were the ones that tensed up. I’ll forever be grateful to him.”
There are still some limitations to what Audrey can do in bed—sex can start slow, new positions often take some adjustment and might be painful at first. She’s found marijuana to be helpful in getting her vaginal muscles ready for sex. Whatever treatment works for a given woman, success rates are usually high. Just don’t put off that visit to a gynecologist.