Sexpert Explores: Vaginismus

All About Vaginismus

The sad reality is that it’s quite possible you’ve never heard of this condition. It’s not commonly included as part of sex education and there’s a general lack of public awareness about it. So, when people experience symptoms, they’re confused by what they’re experiencing, leading to shame and often a reluctance to seek treatment. This is a key reason for why we don’t really know how many vulva-owners suffer from vaginismus. Another reason is that women’s health issues are largely under-funded and under-researched (endometriosis is another prime example of this). As a consequence, some doctors are unfamiliar with the condition and don’t know how to treat it. 

Let’s Break it Down

Vaginismus is the involuntary spasm and tightening of muscles around the vagina in anticipation of penetration.

This tightening can narrow the vaginal opening to the point where nothing can be inserted (tampon, finger, sex toy, penis, speculum, etc.). Some people describe it as hitting a brick wall - a wall of muscle you can’t get through. In other cases, insertion is possible but the tightness of the muscles causes severe vaginal pain. Some people describe it as a burning or stinging sensation as soon as the vaginal area is touched or as penetration is prolonged or deepened. 

The Two Types of Vaginismus

  • Primary vaginismus: Spasms that have been present from the very first attempt of penetration. Often diagnosed after a vulva-owner's first attempt at penetration, whether it’s a pelvic exam, tampon insertion or sex.
  • Secondary vaginismus: Spasms that developed some time later, after a history of pain-free penetration. Often occurs after a more specific event like sexual trauma, a fall or accident, a sexually transmitted disease, a urinary tract or other pelvic infection, childbirth, menopause, a painful medical experience, other pelvic floor muscle disorders, etc. 

It’s important to note that vaginismus is psychosomatic - meaning there’s a mental component that has a very physical effect. What might that look like? Well, for example, someone engaging in penetrative sex for the first time may be nervous. That distress could cause their pelvic floor to tense up, and that tension could be heightened by shame and secrecy due to negative sexual messaging in society. All of this creates a psychological negative feedback loop. Negative past experiences, social scripts and other forms of stress and anxiety all play into the bodily response. 

Because it’s rarely discussed in public, many people who have vaginismus wonder if they are abnormal. Those who have primary vaginismus may even wonder if they even have a vaginal opening. It impact’s people's lives immensely in complex ways. Every person has a unique experience with it, which means there’s no “one size fits all” solution. It’s not as simple as just relaxing because the body has been programmed to respond to certain triggers. The good news is that there are plenty of treatments to explore, and in the meantime there are other ways to enjoy sex without penetration (ahem… clitoral stimulation)!

One of the most popular sought tools for beginning or resuming vaginal penetration are vaginal dilators. They come in a set of different sizes so you can start small and progressively increase over time. The dilators, typically made from body-safe silicone, help desensitize the pelvic floor and form new muscle memory. Start with the smallest size. Insert as far as you can go, stopping when you feel pain, and then hold in place for five minutes. Do this every day and slowly increase up to ten minutes. Dilators aren’t meant to stretch the vagina. It’s about learning to relax, breathe and release the pelvic floor muscles. At Wicked Wanda’s, we have a selection of dilators to choose from depending on your preference:

**Of course, lubricant is a MUST with using any dilator. We recommend our fave lube brand SUTILWe also recommend the Ohnut, for those experiencing soreness or pain, during or after sexual encounters.

Other forms of treatment include working one-on-one with a pelvic floor therapist, a bodywork practitioner, or a psychologist. There’s lifestyle adjustments you can consider such as integrating more mindfulness, masturbuation, exercise, socialization, sleep and other healthy habits into your life. There’s even a surgery available to inject Botox into the vaginal muscles to prevent involuntary contraction. However, some folks who have undergone this procedure have noted that it does not adequately address the mental health training component of healing vaginismus. 

For more information, check out The Vaginismus Network, a wonderful organization supporting and connecting people with vaginismus and raising awareness about it. 

Written by Natalia Jaczkowski

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