Dear Asking For a Friend,
After years of painful sex and not being able to use tampons comfortably, I have been diagnosed with vaginismus. I am finding it hard to talk about with my doctor and my partner about it, and I am worried that it’s going to get worse. Am I ever going to be able to enjoy sex?
Signed, Painful Sex
Dear Painful Sex,
Vaginismus is when the vaginal muscles contract involuntarily during penetration. It can happen during sex, making the insertion of a penis, or even genital touching, very painful, but vaginismus can also make using tampons uncomfortable.
Some people may experience vaginismus after gynecological surgery or radiation. In menopause, when estrogen levels drop, increased dryness may lead to these involuntary contractions. And while some may believe that a history of physical or sexual abuse is a risk factor for vaginismus, there is very little evidence supporting this in research literature.
Without a doubt, vaginismus can be a stressful experience and it can also put a strain on a relationship. Unfortunately, it doesn’t get as much attention as erectile dysfunction, which can make people who are going through it feel alone.
Dr. Caroline Pukall, psychologist and professor at Queen’s University, and director of Sex and Relationship Therapy Service Psychology Clinic says that often people with this condition are invalidated, dismissed, or given poor advice, such as “have some wine, that will loosen you up.” She adds that the perception that ‘everyone’ is having sex or that they are the only one experiencing the condition, contributes to a feeling that something is very wrong with them.
Pukall suggests that there is still a lot of societal shame around female-typical genitals, and those affected by vaginismus may not have the language to express what they are going through. They also may be hesitant to share a deeply private experience with others. And even if someone is comfortable talking to a healthcare provider about this, she notes, they may be dismissive or they may not have the training to ask helpful questions.
Although it’s rare, some people may experience a sudden onset of vaginismus. Pukall suggests that pain occurring in the genital area, such an infection, or something that is physically or psychologically traumatic, can lead to unexpected or secondary vaginismus.
Although this condition can take a physical and an emotional toll on the person going through it, treatment is available. Some effective strategies include working with a sex therapist, practicing relaxation techniques and hypnosis. Vaginal dilators, which are inserted into the vagina by a healthcare professional to help expand vaginal tissues, are another option to relieve the painful symptoms of vaginismus. Targeted exercises, guided by a pelvic floor specialist, can also improve discomfort.
As for keeping your sex life alive while exploring treatment options, adding lubrication to the mix, trying different positions, oral sex and masturbation can also help provide relief.
It’s not an easy subject to discuss, but it’s important to share how you are feeling with your partner — the support of a therapist can help make the most of these conversations. There are proven therapeutic benefits in talking openly about your emotions and positive health impacts in releasing shame.
Changes in sexual health can happen to anyone, but asking for help can reduce symptoms and ease the emotional burden you’re experiencing.
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