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What Is Vaginismus?

By Matty Silver, Sex Therapist on June 26, 2014 in Other

Photo: Lolo Jones

Photo: Lolo Jones

As a sex therapist, I see many women who come from a cultural or religious background where sex before marriage is frowned upon or not allowed at all; they sometimes end up with a condition called ‘vaginismus’, which can result in unconsummated marriages.

Women who suffer from vaginismus find that attempts at sexual intercourse are unsuccessful or very painful. The condition is caused by the involuntary contraction of the muscles around the entrance to the vagina. The spasm constricts the vaginal opening, making it virtually impossible to have intercourse. The man cannot penetrate and it feels like he has hit a brick wall.

As this is often experienced on, or after, the wedding night, you can imagine how distressing this is for a couple that doesn’t understand what is happening. They have waited so long and now having intercourse is impossible.

Women with vaginismus may feel sexually inadequate and can experience feelings of intense shame and failure. The male partner may experience loss of desire and problems with erections. The combination of erectile difficulties and vaginismus is not uncommon. He fears hurting his partner and loses his erection whenever he tries to penetrate. Or he may ejaculate before he can penetrate.

It is such a taboo that couples are often too embarrassed to discuss the issue with family or friends and so they suffer in silence. They avoid questions from the family about why they don’t have children yet and feel extremely sad when their friends tell them what a great sex life they have.

Some couples take years before they finally look for help and then they are often misdiagnosed. It is quite unbelievable that in Australia many GPs, and sometimes even gynaecologists, do not know about this condition.

My clients are often told “there is nothing wrong with you; it is all in your head”, “keep trying, you will get used to it”, “use an anaesthetic cream” or “drink some alcohol to make you feel more relaxed”.

Some women were told their vaginas are too small and they need an operation to widen its entrance or that they need to undergo a hymenectomy, a procedure to remove all or part of the hymen.

Most of the women I see have spent much of their lives in Australia, and they are often university-educated professionals in their mid or late twenties who are settling down and getting married. They may not be that religious, but out of respect for their family and culture they have decided not to have sex before marriage.

Most women with vaginismus were told by their mothers not to use tampons when they were young; they just did not swim or go to the beach when they had their periods. They were told not to insert any object into the vagina for fear of breaking the hymen. Most had inadequate sex education, received unhealthy sexual messages and were told that sex would be extremely painful and that there would be blood.

Vaginismus is easily treated with counselling, education, anxiety reduction and retraining of the pelvic floor muscles. Psychosexual education is important, as it is essential that the woman gains knowledge of her sexual anatomy. Through counselling she can free herself of the moral beliefs that can contribute to her condition.

Post-counselling, I refer my clients to a pelvic floor physiotherapist who specialises in this area. The treatment of vaginismus involves unlearning the fear-contraction reflex and being taught to keep the pelvic floor muscles relaxed during intercourse.

Successful treatment does not require drugs, surgery, botox injections, hypnosis or any complex invasive techniques, and a full recovery is possible.