Why Vaginismus Is More Than Just Painful Sex
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Content note: vague mentions of sexual abuse and trauma
About five years ago, I began to feel pain whenever I inserted a tampon. That was the first sign of trouble. Then, I started having painful sex to the point where penetrative sex was no longer an option for me. Luckily, I have an understanding partner who was able to explore other ways to be intimate, but it was still a frustrating pain to navigate.
The narrative I had in my head was that I was broken. I held a shame about my body that felt inexplicable. After a while, it just became a part of my life that I accepted. My partner and I didn’t have a high sex drive to begin with and, I switched to period underwear that made my pain feel like it was manageable. But after a while, I knew this wasn’t the way I wanted to live and pursued a vaginismus diagnosis.
What is Vaginismus?
Vaginismus is a condition where the vaginal muscles involuntarily contract in the event of penetration. There can be many reasons vaginismus occurs. If you have experienced painful sex in the past, have a history of sexual abuse and/or trauma, have complicated emotional facets surrounding sex, have experienced menopause, or have a history of reproductive cancer, you can develop this condition.
I’ve had issues with vaginal cysts and I thought maybe that was causing my pain. Reproductive health issues run in my family, so I wasn’t surprised when something like this arose. Previously, I had experienced ruptured cysts and although I recovered with relative ease, I later had to have surgery to have some cysts removed, which ended up being fairly traumatic. My cysts were removed, but my pain persisted.
One of the more frustrating aspects of vaginismus is that it was dismissed the first few times I talked to a doctor about it. So many people expect sex to be pleasurable and pain-free. However, that’s not always the case for people with vaginas. My doctors told me to use more lubrication, have sex more often, and one even prescribed me a muscle relaxer to take before having sex. All of these treatments were bandaids over a much larger problem that I need(ed) to tackle at the root.
How Do I Get Diagnosed With Vaginismus?
Because vaginal pain can be associated with many different conditions, a vaginismus diagnosis can be referred to as a “diagnosis of exclusion,” since many doctors go to lengths to rule everything else out before diagnosing vaginismus. This is why it’s important to have doctors you can trust and who are willing to search for a solution with you.
In many cases, you may have to switch doctors and self-advocate to reach a solution and treatment, but you deserve to be heard and treated. While I am not a doctor, and every person will be different, I self-advocated for my diagnosis by going to the doctor and telling them I have vaginal pain when I experience penetration of any kind and wanted to explore a vaginismus diagnosis. My doctor examined me to rule out any cancers, cysts, or other urgent conditions and then made a treatment plan.
Vaginismus and Trauma
Let’s face it, the US education system has an abysmal sex education program. Many of us are not taught comprehensive Sex Ed and/or may have religious backgrounds that complicate our relationship to sex because of purity culture.
Many people also have a history of sexual abuse or trauma, which has recently become more common to discuss openly because of the #MeToo movement. In 2017, I joined alongside many people on Twitter and Facebook posting the hashtag #MeToo as a survivor of childhood sexual abuse.
In my personal life, this ignited a reckoning with my childhood past and my current relationship with sex and intimacy. While this was necessary for my healing, there was undoubtedly a connection between my vaginismus diagnosis and being more verbal about my past. Trauma and vaginismus can be linked, but that’s not the only cause. If you have a history of trauma, it’s important to know that there is support for you. Finding a care team such as a doctor, gynecologist, and/or therapist is an important part of treatment.
How Do I Treat Vaginismus?
The good news is that vaginismus is treatable, and there are ways to get support no matter the cause. Making a treatment plan can often be two-fold: physical and psychological. I needed to do a lot of mental and emotional work in therapy before tackling the physical aspects of vaginismus. For me, this looked like finding a therapist that I felt extremely comfortable with and could trust before spending many months unpacking my relationship with pleasure, intimacy, and desire.
An important part of my mental discoveries was realizing that I am a person who experiences responsive desire, as opposed to spontaneous desire. According to Emily Nagoski, author of Come As You Are, responsive desire arises in response to sexual pleasure. In contrast, someone who experiences spontaneous desire may experience the “standard” out-of-the-blue desire for sex. Realizing that it’s totally okay and normal to experience responsive desire helped me navigate my sex life, relationship, and vaginismus healing with more compassion and understanding.
In many cases, the mental work of unpacking your relationship with pleasure and intimacy can be enough for treatment. But for others, it requires additional physical therapy to overcome the condition. Some may recommend a sex therapist to help you learn more about the different body parts, and it may even be a collaborative experience to become more comfortable with your partner.
You may also be able to see a pelvic floor physical therapist, who will do similar things to help you get to know your body, but you will most likely be in a doctor’s office without your partner (although I’m sure you could ask for them to be there if you wanted). Throughout this process, a physical therapist may lead you through deep relaxation techniques, help you learn how to use a vaginal dilator (which are basically medical dildos), or use different massages to help your muscles relax.
There Are Many Ways to Be Intimate
One of the biggest things I had to do was unpack my understanding of sex, pleasure, and intimacy. While learning that I experienced responsive desire was a huge “Aha!” moment for me, it also made a huge difference when I began to realize that there were many ways to be intimate and experience pleasure. If you have a vagina, penetrative sex isn’t the only way to have sex; it is also not the only way to experience pleasure.
Self-pleasure may also be a good thing to explore while going through the healing process. We may be taught that in many different ways, but sex looks differently across sexuality, gender, and experience. Navigating vaginismus while in a relationship can be complicated and bring up a lot of emotions, but keeping communication open and honest, while also exploring different ways to experience pleasure can make the treatment process much easier to navigate.
You Are Not Broken
After a long road of confusion, frustration, healing, and gentleness, I am about to start my pelvic floor physical therapy journey. You’d think after all this, I’d have some big redemption story about how I’m healed and no longer experience vaginismus. That’s not the case. I am still very much on the journey, and I think that’s important to talk about, too.
I only know so much about this condition because I’ve researched, talked to people with similar experiences, and have finally found doctors who want to find a solution. I hold onto this mantra during this process: "You are not broken.” So much about being in pain can make you feel shame and grief, but you are not broken. Healing is possible, and you are not alone.