What some of you may not realise is that our CEO Jodie West is a women’s health advocate having lived with endometriosis and a number of other health conditions that primarily affect women. That the reason she became a sexologist was due to her own health issues that impacted her sex life. At Bliss we fully support her in spreading the word about women’s health issues.
This week we want to raise awareness around Vaginismus. Some of you may have heard it before but many others will be thinking Vagi-what?!? To be honest we are not surprised because many women suffer in silence not even realising that the symptoms they have even have a name. So we thought we would ask Jodie some questions about vaginismus.
What is Vaginismus?
Jodie: Vaginismus is the term used to described as the ‘involuntary spasm/contraction/reflex of the muscles surrounding the entrance to the vagina, making penetration impossible and/or painful, which causes personal and/or relationship distress.’ *1
There are 2 types of vaginismus;
Primary Vaginismus which occurs where a woman has never, at any time, been able to have pain-free sexual intercourse.
Secondary Vaginismus occurs when a woman develops Vaginismus after having been able to engage in pleasurable pain free intercourse previously; this is usually due to trauma or surgery.
What are the main symptoms of vaginismus?
Jodie: Every women’s experience of vaginismus will be different. These are some of the common symptoms;
- Involuntary tightening of the pubococcygeus muscle (PC Muscle). This makes penetration of anything from a finger, tampon, or penis difficult or impossible. It can make it feel as though the vaginal opening is too small, like it is closed, some even describe it as like a wall.
- Burning, tearing in pain, it can range from discomfort to extreme pain.
- With the discomfort or pain can come Fear and anxiety about penetration.
- It can happen every time penetration is attempted from sex to medical examinations. Or it can be intermittent.
How prevalent is vaginismus?
Due to the shame and embarrassment that women feel about this condition it is believed to be a largely under reported women’s health condition. ‘The prevalence of vaginismus in the general population is 1-6%, and this ratio rises to between 5% and 17% in sexual dysfunction clinics.’ *2 Women living with this condition often do not know that they are not alone in this and do not need to suffer in silence. That there is help that is more often than effective in treating this involuntary pain condition.
How can it be involuntary?
Jodie: The reality of vaginismus is that anything that may cause pain from a partner, to a doctor’s examination or tampon is perceived as a threat and the brain and body react involuntarily. It is not a choice a woman makes, it is not in her head and she is not frigid. For those that would like to understand this a bit better, if every time you got given chocolate you also got hit with a hammer, you wouldn’t want chocolate anymore now would you? You would actually avoid anything to do with chocolate, wouldn’t you? Now the thing with vaginismus is you can train yourself to not react to the potential pain. Or another way of thinking about it would be – if you get poked in the eye, your eye closes to protect you, to protect you from the potential pain but you can train yourself to be able to put contact lenses in. You can train the pelvic floor muscles that are contracting in vaginismus. There is support to help you do this.
What or who can help?
Jodie: A part of retraining your pelvic floor is understanding the cycle of pain and working with health professionals that specialise in both the pelvic floor and understand pain. You will learn that not all contact is painful and that it is possible for vaginal penetration to happen without pain. We have physiotherapists, exercise physiologists, doctors and therapists that help us deal with the impact of the pain cycle on other parts of our bodies so why not for vaginismus and pelvic floor pain. You can apply the cycle of pain below to pretty much any part of your body.
The Cycle of Pain
This training involved the use of dilators, starting small and gradually increasing in size to stretch the muscles, relax around them and gradually gain confidence. Like lifting weights at the gym it is important to start small and build up at your own pace, as your body adapts.
A Pelvic Physiotherapist can do a pelvic floor assessment and give you the right relaxation, movement and breathing exercises in this training. A Sex Therapist can work in conjunction with them to support you in training and working through any psychosexual elements which may be contributing.
The muscles that form the pelvic floor are really no different to any other muscle in our body. If they are held tense for extended periods of time or is not used regularly, they get tighter and are painful with we try to use them. The vaginal wall and the muscles in the area are no different, if you are struggling with vaginismus these muscles may be tighter due to lack of use or stretching. When we are stretching our hamstrings, we put the muscle on stretch and breathe through to relax the muscle. The dilator and breathe techniques you learn with your pelvic physiotherapist are designed to do much the same. A good lubricant is also essential, especially when starting out. Every women, vaginismus or not needs to have a quality lubricant available for use. In the case of vaginismus it is essential to use alongside your dilators. I recommend Sliquid.
There is also a point where you may be ready to try a slim line vibrator to help you relax and increase pleasure in the process. You can use them in conjunction with your dilators and other relaxation exercises.
A sex therapist and or your pelvic physiotherapist can also work with you on involving your partner in the process when you get to that point. The sex therapist can support you in communicating with your partner through the process and helping you both understand how you can stay connected and intimate if intercourse when intercourse is not possible and how to work together when it is.
Final words of wisdom?
Jodie: You are not alone. You are not broken. You do not have to suffer in silence. Having these health care professionals to support you through the retraining of your pelvic floor can give you the space and help to explore your feelings. It may be exploring where the issue may have started, things that may be maintaining the cycle, what is going on as you progress through the process or even simply how to prioritise this care and sticking to a routine. Any issue that impacts health or normal functioning, can be emotional add sex into the equation and a little help can go a long way.