Guest Post: Vaginismus

20 Jul

This is a guest-post from a reader of MMP addressing the not-uncommon but not-often discussed subject of Vaginismus. We hope you find it as informative and thoughtful as we did. ~The MMP Sister Wives

I grew up in the church, had my first boyfriend at age 21, and married at age 26.  I guess you could say I was a “late bloomer,” but I was well educated about sex by the time I got married.  I was forced to educate myself because I had been diagnosed with something called vaginismus, a condition which causes painful intercourse.  Though this condition is not terribly rare, I found that few people understood it and few resources about sex even mentioned it–often, when it WAS mentioned, it perpetuated unfair stereotypes about the women who suffer from it.  It was very isolating, but having a name for what I was going through was also liberating and comforting. 

What is vaginismus?
Time for a quick anatomy lesson. Have you heard of Kegels exercises, that pregnant women do? Where you try to stop your urine mid-stream? Well, when you do that, you are tightening the PC muscle, or your pelvic floor muscles. In vaginismus, those muscles involuntarily tense up and contract when something approaches or begins to enter the vagina. (image of PC muscle)

What are the symptoms?
Many women who suffer from vaginismus describe intercourse as “hitting a brick wall.” That wall is the PC muscle. As it contracts, it tightens around the vagina, essentially completely closing the opening. For me, vaginismus meant I had difficulty inserting or removing large tampons, and gyno exams were extremely painful. The doctors would tell me to “just relax,” but the thing was, I was as relaxed as I could make myself be. My PC muscle would contract without me telling it to—it did it on its own, like a reflex.

What causes vaginismus?
Unfortunately, there’s lots of misinformation and misunderstanding out there about women with vaginismus. Even doctors, when dealing with women with a tight or spasming pelvic floor, may repeat harmful—and completely untrue—stereotypes about women with this problem. Some of these harmful stereotypes and beliefs are that you “just need to relax,” you have hang-ups about sex, you don’t like sex, you don’t love your partner, you don’t trust your partner, you have psychological issues, you have “good-girl syndrome,” or you’ve been raped or sexually abused, or that sexual pain/discomfort is normal and you just have to get used to it. Of course, some these things may lead to vaginismus in some women—but guess what: sometimes vaginismus just happens! And it doesn’t mean there’s something wrong with you!

Is there a cure?
Yes, there are effective treatments available. An experimental treatment involves the injection of Botox into the PC muscle. This prevents the muscle from spasming for the next six months or so, during which time the woman can painlessly have sex or insert dilators. After experiencing successful, painless penetration, the PC muscle’s tensing reflex disappears. Unfortunately, since this treatment is experimental, you are unlikely to find a doctor willing to do this for you.

Most women overcome this problem with physical therapy and/or using dilators. (image) It’s a specialty within physical therapy called pelvic floor physical therapy; therapists who specialize in this also treat patients with incontinence problems or chronic pelvic pain. The therapist may use some combination of gentle massage, biofeedback to help you learn to control your PC muscle, Kegel exercises with a focus on completely relaxing the muscle, and stretching. Physical therapists can also tell you about which sex positions are better than others if you have vaginismus.

When using dilators, a woman should start with a very small size, whatever is comfortable for her to insert. This might be a tampon, or maybe even just her pinky finger. Gradually, over the course of a few weeks or several months (don’t rush it!), she will use larger and larger dilators, until she works her way up to a dilator that is the size of her partner. More detailed information on dilating.

What should I do?
Talk to your doctor. Be pushy, if you need to. As I suggested above, some doctors are not super understanding or supportive about this. I had one such doctor, but because I already knew I had this thing called vaginismus, I basically made her give me the referral to physical therapy (without the referral for your insurance, PT is prohibitively expensive). And I had many gyno exams before anyone even said the word “vaginismus” to me. If this post sounds like you, go tell your doctor, “I think I have vaginismus.” Because they might never bring it up otherwise.

Get your partner involved! He needs to know about this. He can help you get relaxed, do your stretches with you, or sit with you as you do your dilating. Here is a site with some good ideas about how to get your partner involved. At any rate, it’s important he understands what is going on with your body. You’re not rejecting him; your PC muscle is simply experiencing a reflex action to a certain stimulus.

DON’T have sex if it hurts. This can reinforce the PC muscle’s reflex to spasm, making it even more painful next time. Don’t make penetration the focus and central feature of your sex life—there are SO MANY AWESOME things you can do sexually, things that are arousing, exciting, and satisfying, that don’t involve penetration!

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17 Responses to “Guest Post: Vaginismus”

  1. Eliza R. July 20, 2011 at 2:20 pm #

    Fanny, thank you *so* much for this information!! I had no idea about vaginismus. I really appreciate this sort of practical knowledge and advice. Bless you.

  2. CuriousVirgin July 20, 2011 at 7:39 pm #

    Thank you for sharing this.

    I have a question that’s only tangentially related, so if it’s off topic, I apologize, but I didn’t see any related posts. I may be getting married soon, and I’m a virgin. I’ve heard that some people need a little extra lubrication at the beginning in order to make penetration possible and comfortable. (My hormones are crazy, so I suspect I may be one of those people.) Can you recommend a few brands or types that work well? I’m hoping for ones without a lot of synthetic chemicals. (Obviously I would want to do a skin test for allergic reactions before the wedding night; that’s not the kind of surprise I want to be getting then.)

  3. Mouse July 21, 2011 at 3:32 am #

    This was very informative. I knew about vaginismus but didn’t really think about it much. In my experience doctors are quick to brush aside concerns about your sexual health unless it involves an infection or something you can do a blood test for.

    I had a very bad time after giving birth, I’m still convinced I was sewn up incorrectly – the doctor asked me if my inner labial lips were uneven as she was stitching me and I said “yes” but the result was much, much shorter and lopsided than it used to be. I had a tremendous amount of pain with the scar tissue and every doctor I saw just told me that I had healed fine and the pain would go… Ha! I had significant pain issues for at least 18 months afterwards and now that I am pregnant again I’m experiencing pain and other issues around the scar tissue and at the vaginal opening that I’m assuming are down to hormones. My doctor has just suggested using lubricant, but that hasn’t helped.

    I nearly bought a set of dilators, and depending on how this birth goes it is probably something I should look into again.

  4. Whitney July 21, 2011 at 3:47 am #

    Mouse–
    I’m the author of this post. I’m sad, but not surprised, to hear that your doctors dismissed your pain like they did mine. I hope you can find a good doctor (or PA or NP, they seem to be a little more understanding) who can help you with this. Something I wanted to address in the post (but it was getting too long) is vulvodynia and vulvar vestibulitis. These are other sexual pain disorders experienced by women. It sounds like what you are experiencing might be similar to these conditions. Right now, there’s no cure for these, but there are treatments available.

    Btw, don’t you love when doctors just tell you to use lube? Do they think we’re complete idiots? “Oh, lubricant? Gee, I’d never even thought of that! I’m sure that will solve all my problems!”

  5. Mouse July 21, 2011 at 6:37 am #

    Thanks Whitney!

    I did come across vulvodynia and vulvar vestibulitis the other day (which prompted a “wow, this is totally what I’m experiencing!” email to my husband) and I’m fairly confident that my current problems are due to the hormonal shifts pregnancy has caused. From what I can gather though, they basically know nothing about it – not what causes it, not what fixes it, it is just a catch all for “oh, your icky lady bits hurt? have some numbing cream and lube!”

    I did find this website helpful- http://vvssupport.wordpress.com/category/vestibulodynia/
    just to read about other people having the same problems, even though mine are not as severe.

  6. KaralynZ July 21, 2011 at 11:01 am #

    Curious Virgin – quick note: your general lube section of any sex store has two types you would be looking at water based and silicone based.
    You’re probably going to want to go with a generic, water-based lubricant. Most packaging should say if it’s aimed at those who might have allergies. You may also want to look for glycerin-free. (Glycerin makes it very tacky in my experience as well as the possibility of an allergic reaction, but it doesn’t bother some folks.) Before my wedding people talked up Astroglide a lot to me but I had a very bad reaction to it.

    I recommend something simple like Wet Naturals (this site has free shipping, and I’ve ordered from it in the past, if you’re preferring to order online rather than look around local stores. Also, cheap condoms!)

    http://www.condomdepot.com/product/detail.cfm/pnid/214/nid/294/pid/2863

  7. Fanny A July 21, 2011 at 11:30 am #

    Yeah, you really do have to get some samples and try them, regarding lube. I have a terrible reaction to the preservatives in many water-based lubes, including KY. Days of chemically burned skin does not a happy mama make. I personally have much better luck with the higher-end silicone lubes. Many sex shops sell sample-sized packets of literally dozens of different lubes, for under $1 each. It’s totally worth it to try them this way until you find the one that works for you.

  8. KaralynZ July 21, 2011 at 11:38 am #

    Days of chemically burned skin does not a happy mama make.

    Amen. I speak from experience when I say, this is NOT what you want to happen on your honeymoon. Most miserable week of my life.

    I have yet to try silicone lube because most of our toys are silicone and you can’t combine the two- and I honestly don’t trust one of us not to grab the wrong bottle in a moment of excitement.

  9. KaralynZ July 21, 2011 at 11:42 am #

    Oh and, again, experience here. If you’re testing out samples beforehand to make sure you have no adverse reactions? Make sure you are actually testing them in your vagina, because if you’re like me, you can rub them on your hands and arms all day long but once you get those oh-so-sensitive mucous membranes involved it’s a whole different ballgame.

  10. Whitney July 21, 2011 at 2:18 pm #

    CuriousVirgin–
    My favorite brand of lube is called Slippery Stuff. It’s water-based and odorless, not at all irritating, so I think it’ll be a good one for you. It’s not sold in stores, but can be found online, and since it’s inexpensive, you can feel free to use as much of it as you want! Even women who DO have plenty of natural lubrication often use lube, as it reduces friction and can just make things a lot easier and more comfortable, especially if the guy is bigger.

    I suggest you read up on lubes online. Some people say you can use almond oil or olive oil, but I have read that things like that can promote yeast infections. Definitely don’t use anything that has sugar in it, as that can also promote yeast or bacterial infections! For the most part, the folks that make lube understand that it needs to be non-irritating and safe for vaginas, so mostly it just comes down to personal preference.

  11. Fanny A July 21, 2011 at 6:07 pm #

    Food oils, on the internal bits of a woman, are a bad idea. Stick with lubes meant for those body parts. You don’t want chemical burns and you don’t want a yeast infection.

    And KaralynZ is correct- you can rub lube on your arm all day and not have a reaction, but until you get it on your inner labia and the mucous membranes, you don’t know what kind of reaction you’ll have- so buy the samples and have fun weekend playing with them.

  12. Anon July 24, 2011 at 5:54 pm #

    This is slightly of subject but I had a question for you women out there. My husband and I have been married for 11 years and after reading several of these post we have started to really talk and redefine or sexual relationship. In other works we have been going at it like crazy! We have had sex everyday this week and which is a lot for us. Is it possible to over work your pelvic floor due to a lot of sex and origasims? I don’t know if this question makes sense but I am curious to your thoughts.

  13. Anon July 24, 2011 at 5:56 pm #

    Sorry about the spelling mistakes, I didn’t re-read my post befor I posted it 🙂

  14. Fanny A July 24, 2011 at 10:49 pm #

    Is it possible to over work your pelvic floor due to a lot of sex and orgasms?

    Nope. Like any muscle, your pelvic floor benefits from frequent exercise and use. I know personally of three couples that have made a commitment to have sex daily- be super glad that you and your DH are so well matched. I wish I had been so well matched with my (now ex) husband.

    Enjoy yourselves!

  15. VirginAskingQuestions July 25, 2011 at 2:21 am #

    Fanny,
    I think it would be REALLY interesting if you could get one (or more) of the couples to talk about their decision in a guest post. How did they decide to it? What if someone really ISN’T in the mood? or sick or something? Has their relationship always been this way, or did they consciously decide that something wasn’t working and this was how they fixed it? How did their relationship change? Do they have kids? Ooh, how interesting. There was a book – which I can’t find and searching on amazon and google finds me a DIFFERENT book, not the one I want. Where a husband and wife decided to have sex every day for a year no matter what and it talks about their experiences and how sometimes neither one wanted to do it, but they’d made a commitment… I should’ve checked it out at the library when I saw it, but I thought next time… and now I don’t remember what it’s called… sigh.

  16. KaralynZ July 25, 2011 at 8:54 pm #

    V – I started a comment in response to this but it is so long now i may just submit it as a guest post, ha.

  17. VirginAskingQuestions July 26, 2011 at 5:18 am #

    Can’t wait to read it. Hopefully it gets posted eventually. :o)

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