Sexual Health: Let’s talk about the painful condition Vaginismus

When it comes to women's health, we have a lot to contend with.

While endometriosis and Polycystic Ovary Syndrome affect millions and women are becoming rightfully more vocal about them, vaginismus is a condition we don't hear about often.

Anywhere between 7% and 68% of the female population are living with vaginismus according to studies, with health experts believing it's a relatively common condition.

Despite the large number of women being impacted by vaginismus, social awareness about it remains low.

What is vaginismus?

Vaginismus is a physical manifestation of an underlying psychological problem that can lead to painful sex, making a type of dyspareunia — the medical term for persistent pain before, during or after sexual intercourse

It can occur at any time in a woman's life, but there is often a psychological component linked to its development.

Vaginismus is a multi-factorial condition that is more likely to occur in women who have:

• Anxiety
• Experienced trauma (of any kind)
• Had injuries from childbirth (such as a tear)
• Following childbirth
• Have had pelvic or vaginal surgery
• After chronic infections (such as repeated UTIs or yeast infections)
• Have been sexually assaulted or abused

Reardon, owner of NOLA Pelvic Health, told TODAY that vaginismus is also common in women from strong religious backgrounds, where they may have been told sex was a bad thing.

It can be painful, both physically and mentally, and can cause millions of women a lot of internalised shame.

Shame around a health condition can stop people from seeking answers, which, in turn, stops them from accessing treatment.

How does vaginismus impact sexual intercourse?

People who have vaginismus experience an involuntary and unconscious spasm of their vaginal muscles, according to the Cleveland Clinic.

This vaginal muscle spasm is a reaction to the fear of oncoming vaginal penetration, meaning inserting tampons or fingers, having gynaecological exams using speculums or other medical equipment, or intercourse causing muscle tightness and/or halting penetration.

Women with the condition can still experience orgasms through clitoral stimulation, but treatment is required to feel comfort and pleasure from penetrative sex.

Symptoms

• Pain during penetration.
• Pain during sex.
• An inability to have sex at all or have something inserted into the vagina

Removing stigma, educating and bringing awareness to vaginismus

Awareness about conditions can help motivate those who suffering to seek help and feel less alone in their health battles.

Meghan Trainor opened up last year about having vaginismus, admitting that she thought all women felt pain during sex on her podcast, Workin’ On It.

“I was told I have something called (vaginismus),” Trainor told her guest, Trisha Paytas.

“I thought every woman walking around was always in pain during and after sex. When I was making this baby, I’d have to ice myself after.”

The singer's confession highlighted a key piece of education for women: Pain during and after sex is not normal.

Vaginismus treatment

All women deserve to feel comfort, relief, and pleasure from sexual activity, something that Vaginismus can act as a barrier for.

Luckily, there is treatment available. In 2024, no woman should suffer in silence or be dismissed when it comes to her health and wellness.

According to the Cleveland Clinic, several treatments can help with overcoming the condition.

These include:

• Topical therapy: Topical lidocaine or compounded creams may help with the pain associated with this condition.
• Pelvic floor physical therapy: A physical therapist will teach you how to relax your pelvic floor muscles.
• Vaginal dilator therapy: Vaginal dilators are tube-shaped devices that come in various sizes. Their primary purpose is to stretch the vagina. People with vaginismus use dilators to become more comfortable with, and less sensitive to, vaginal penetration. Your provider may recommend first applying a topical numbing cream to the outside of the vagina to make insertion easier.
• Cognitive behavioural therapy (CBT): CBT helps you understand how your thoughts affect your emotions and behaviours. It’s an effective treatment for anxiety, depression, and post-traumatic stress disorder (PTSD).
• Sex therapy: Trained sex therapists work with individuals and couples to help them find pleasure again in their sexual relationships.

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