Breaking The Silence: What is Vaginismus?
Despite the arousing and adventurous scenes we’re perpetually inundated with from television shows and often-embellished gossip between girlfriends, sex does not always consist of titillating trysts and orgasmic thrills. Sometimes, it can be unfulfilling and awkward, and for some women, who suffer from a relatively undiscussed condition called vaginismus, sex simply isn’t possible.
What is vaginismus?
“Technically, vaginismus is the impossibility of penetrating the vagina,” says Marina Vecino Pérez, a Dubai-based physiotherapist who specializes in pelvic floor rehabilitation. She explains that there are different types and severities of the condition – from women who are unable to use tampons to those unable to undergo gynecological check-ups or sexual intercourse without pain, as the muscles around the entrance to the vagina involuntarily contract, essentially “closing” it up. Vaginismus reportedly affects around 5 to 17 percent of women – though the actual number is likely much higher, since many cases go unreported due to shyness and stigmas surrounding women’s sexual health.
Many factors can contribute to vaginismus, and a great deal of these are psychological. Some women may fear their vagina is too small or may be put off by an unpleasant first sexual encounter or previous medical experience “down there.” Others have been conditioned to believe that sex is shameful – a common occurrence in Middle Eastern and Asian cultures.
Cultural taboos can be a cause of this condition
“Unfortunately, we live in a culture in which talking about the female body and healthy sexuality is a taboo, and problems with sexual performance are even more taboo. “Many of us grow up with a lack of knowledge. We are taught to be ashamed of talking about sex, but then try to follow wrong standards set by the porn industry,” explains Pérez. Mainstream movies and television shows certainly paint a primarily pleasure-filled picture of salacious sex, replete with romance, sensuality and ecstasy. Netflix’s Unorthodox series was an exception, depicting the struggles of young Jewish newlywed Esty, who is unable to have sex with her husband for a year due to vaginismus.
According to Pérez, numerous myths inspired by cultural and religious traditions relating to sex can be misleading, like assumptions that sex (particularly for the first time) is painful, and that the hymen is a “wall” that closes the entrance to the vagina.
Sameera Qureshi, the US-based occupational therapist and educator behind @SexualHealthforMuslims has hosted webinars focusing on vaginismus, and emphasizes that it’s important to first rule out medical conditions and factors before diagnosing the condition. “Vaginismus is pretty complex,” she says. “It can be neurological, it can be hormonal, it can be physical or a combination of those.” In her work, Qureshi places a particular focus on Muslim communities, offering them accessible sex-ed grounded in spirituality and psychology. The way that sex is often shrouded in social stigmas, she believes, can play a part in causing sexual dysfunctions.
“I think what we're seeing within the Muslim population, is that lack of sex-ed and knowledge about the body, combined with fear- and shame-based messages about sex. This can cause us to disconnect from our bodies, especially our pelvic floor,” says Qureshi. She explains that research has shown that women’s pelvic floor muscles can store stress, tension and trauma, just as our shoulders or jaw can. “So, there's this kind of brain-body connection where we fear sexual intimacy, and fear even understanding our vagina. Without knowing our bodies there can be a subconscious response, where unconscious muscle tension can happen when sexual intimacy or intercourse is attempted, or even when thinking about sex or a pelvic exam,” she says.
How to treat it
There are numerous courses of treatment for women diagnosed with vaginismus – from practicing relaxation techniques to opting for Botox injections to help relax the muscles around the vagina. Pérez offers support through physiotherapy for the pelvic floor, and says that the first step is identifying the root of the problem together with the patient, and sometimes with the additional support of a gynecologist or sexologist. “We work on relaxing the area together, first with information and then with physical exercises and manual therapy, just like with any other muscle of the body,” she explains. Vaginal dilators are a popular “prop” that Pérez uses for treating vaginismus – women are advised to start small and work their way up to larger sizes.
Inform, educate and enlighten
Clearly, we need to raise more awareness about vaginismus, identifying it as a common condition that affects women across the globe and requires psychological or physical remedies. “Spreading information is the only way, along with having proper sexual education based on self-esteem and in the knowledge of the body, without stigmas,” says Pérez. This is particularly important in countries where curriculums are influenced by outdated, patriarchal customs and attitudes about sex and women’s bodies. “The anatomy of the body and biology should not be determined by culture or religion,” believes Pérez.
Unfortunately, some health professionals remain ignorant about female sexual dysfunctions. Many women who have vaginismus report being advised by their doctors to simply have a glass of wine before sexual intercourse, to relax themselves, instead of deeply investigating the root causes and courses of treatment. Having an array of therapists and specialists who focus on the pelvic floor and vagina is essential in helping to demystify the details surrounding this condition.
Only when widespread awareness and education is achieved, will women struggling with vaginismus feel more comfortable and empowered to come forward and seek help; otherwise, they could live forever with a condition that continues to build up psychological fear, inhibiting their sex lives and potentially causing further health distress. “We have to address that whole loop of re-educating someone about sex and their body and then kind of desensitize them to being able to use their vagina for intercourse,” explains Qureshi.
Seeking support through socials
Social media might sound like an unexpected place for women afflicted with vaginismus to find solace, but it’s where Qureshi, Pérez and countless others working in the sexual health and therapy space are building platforms and forging communities. “It's very difficult to talk about your problems if you think that you are the only one struggling with this, especially if your sources of sexual ‘information’ are not reliable,” says Pérez, who shares informative posts about pelvic floor physiotherapy on her page, @PelvicFloorDubaiThere’s also @TheVagNetwork, a community with over 16,000 followers that supports and connects women with vaginismus. Friendly tips, insightful stories, personal anecdotes and inspiring quotes on these platforms can be uplifting and reassuring for those dealing with the daily physical and mental challenges brought on by this condition. They are reminders that they aren’t “broken,” and most importantly, that they aren’t alone.