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Vaginismus is a condition that causes involuntary tightening in the vagina when a woman tries to have sex or use a tampon. It’s a fairly common condition, affecting more than 27, 200 women in the UK and most reported between the ages of 26-35 (53%), according to statistics from private healthcare clinics in the US. This figure, quoted in Linda Valins’ book “When a Woman’s Body Says No to Sex: Understanding and Overcoming Vaginismus” is likely to be higher as women don’t always seek help.
Vaginismus can be ‘primary’ (always present) or ‘secondary’ – developing after physical trauma, a bad sexual experience, childbirth or menopause. Sometimes it happens for no obvious reason and it can be perplexing and distressing, affecting a woman’s quality of life, intimate relationships, family planning, self-esteem and confidence. When you are turned on and want to have sex or trying to insert a tampon with lubricant, it is frustrating when your body puts up a wall to stop you. It can affect a woman’s health and well-being, as she is less likely to go for smear tests and STI examinations.
Physical causes include urinary tract infections, pelvic inflammatory disease, endometriosis, STIs, vulvodynia, psoriasis or eczema, menopause, and birth trauma. This is something your GP will be able to diagnose and treat appropriately. However, in most cases vaginismus is caused by a combination of physical and psychological issues.
“It is a physical manifestation of a psychological issue,” says Mike Lousada, a sex coach and healer specialising in women’s health. “There is a strong link between disgust and a strong moral or religious upbringing and vaginismus.” His work (Psychosexualsomatics) involves a combination of talking therapy and physical massage to help women overcome sexual issues.
“Since vaginismus is a combined psychological and physiological issue the most effective way to treat it is by addressing both aspects. Psychosexualsomatics does this through helping you understand your limiting beliefs around your body and sexuality, and by working directly with the body (if appropriate) to release physical tensions held there. It is a highly effective and rapid treatment for vaginismus.”
Symptoms can vary depending on the degree of vaginismus. A woman may find sex painful and difficult but be ok with tampons. She may be able to tolerate clitoral touch but freeze with vaginal contact. It can cause painful sex and a feeling of tightness in the vagina – likened to ‘a wall’. She may withdraw from any form of touch or intimacy and experience loss of libido and depression.
Vaginismus can be treated and success rates are high. It requires a combination of self-help, counselling with a sex therapist and physiotherapy with a woman’s health physiotherapist. The first step is to keep a diary of symptoms to work out what type of pain you are experiencing and any emotional triggers. Is pain shallow or deep inside the vagina? Your GP will ask questions to make a diagnosis so it’s helpful to think about your answers in advance. Is there any medical history or recent operations/experiences that may be a factor?
If there’s nothing physically wrong you will be offered a course of psychosexual therapy sessions (long waiting lists on the NHS so it can be quicker to go private). Contact the Institute of Psychosexual Medicine for referrals.
Be proactive and positive – this is something under your control and you can work through it. Involve your partner, as they may be feeling shut out, perhaps wondering if they are to blame. Sex therapy will help you to work through any issues around body image and sexuality and you’ll be given practical exercises to do at home involving vaginal trainers in varying sizes. Kegel Exercise Balls (also known as ‘Jiggle Balls’) are a type of vaginal trainer that can be used to help tone the vaginal wall. The aim is to start with the smallest size and weight, gradually working your way up through increasing sizes and weights until you are comfortable inserting the largest ones. This process will take time and there’s no rush.
Small vibrators and dildos are also excellent starting points in helping you regain confidence. The LELO Liv, the Picobong Zizo, JeJoue Uma and Cuddle are small classic shaped vibrators that is not at all intimidating and made of ultra smooth silicone. Alternatively, for those of you who prefer a degree of flexibility in a toy rather than a rigid vibrator, then a flexible vibrator ,such as Rocks Off Slinky Pinky or a silicone dildo may meet your needs. The Fun Factory Amor is a flexible yet firm silky smooth silicone dildo that is not intimidating, extremely easy to use, and a good small size.
You can also try CalExotics Inspire Dilator Kit, this Kit offers 5 dilators that are ergonomically curved and easy to use. Unlike most medical dilators, they are made from flexible, skin-safe, velvety soft silicone.
The easy to use loop handle makes them comfortable to hold, and the gentle tapered shape and varied sizes allows you to increase the insertion size at a rate that is comfortable to you.
For Vaginismus sufferers, lubrication is essential for increasing comfort during sex. Organic lubricant is especially recommended in conjunction with medical dilators or small sex toys to reduce friction, helping you to feel more relaxed.
Getting to know your anatomy and how the pelvic floor works is a good place to start. If you can identify, clench and relax your PC muscles you can stop them reacting reflexively. It will give you control over your body, as you will be able to contract and relax them at will. You are retraining your body’s ‘muscle memory’ and creating new habits.
The PC muscle is large and powerful, forming a figure of eight around your vagina and anus. It is a ring of muscle that stretches, tightens and relaxes to support your bodily functions (to help you urinate, defecate, give birth and orgasm) and it also acts like a hammock to hold your organs in place. The key is learning how to relax it enough to feel comfortable with penetration.
You can find basic Kegel exercises (named after Arnold Kegel) in this ‘More In Depth look at Kegel Exercises’ article. Investing in some Kegel Exercise Balls will really help you get your vaginal muscles under your control, and help you to regain confidence.
If you are unsure about how to do pelvic floor exercises, speak to a women’s health physiotherapist who can teach you ways in which to exercise your PC muscles.
Our bodies are constantly changing as we age – with periods, sex, childbirth, menopause – and this can affect our sexual response and pleasure.
Just because you are having issues with vaginismus it doesn’t mean your sex life is over. You can still enjoy sensual massage and intimacy through Tantra, foreplay, mutual masturbation and oral sex.
You need to be a little more creative and it’s a good time to get to know your body and its sensual responses.
Take the pressure off penetration while you work through your treatment plan. Aromatherapy massage is healing and nurturing and something you can experience with your partner. Fragranced massage candles are perfect for creating a sensual mood, containing essential oils to nourish and soothe the skin.
Pelvic, Obstetric and Gynaecology Physiotherapy – womens health physiotherapists are trained to help women overcome gynaecological issues of the pelvic floor and restore pelvic health. Many WH physios are based in NHS hospitals so ask to be referred by your GP.
College Of Sex and Relationship Therapists : www.cosrt.org.uk
Royal College of Obstetricians and Gynaecologists:
Vulva Pain Society: www.rcog.org.uk
The Vaginisumus Network : www.thevaginismusnetwork.com
Jo Divine also have a health brochure created with healthcare professionals containing suitable products for vaginismus and other gynaecological conditions so please call or email for a copy.