The Ins and Outs of Vaginismus
Words by Janhavi | She/Her
CW: Mentions of sexual harm
Like most born with a vagina, I assumed mine would do everything it was supposed to. Bleed, open wide for the male girth, and even wider for a watermelon-sized human to someday exit my body. I took my vag for granted. A rookie mistake—turns out, I have vaginismus.
While it sounds like a dinosaur name or someone trying to say the word ‘vagina’ with their mouth full, vaginismus is a medical condition. It means the muscles on the pelvic floor and around the vaginal entrance involuntarily tighten, making penetration exceptionally difficult. It makes inserting a finger, tampon, or penis very painful, and also means vaginal examinations are more distressing than usual.
Before being diagnosed, I’d never heard of vaginismus. It wasn’t completely due to social stigma, which implies people speak about it—just in hushed tones. Unless you have it, there’s only a microscopic possibility that you know it exists.
In Season 2 of Netflix’s Sex Education, during a hookup, a character reveals that they have vaginismus and therefore can’t have sex in the way their partner had assumed they could. What followed was an informative and unapologetic explanation of what having that condition meant, followed by an enthusiastic conversation around alternative forms of sex.
When I watched this scene, my heart stopped and tears rolled down my face. I had never seen mainstream media address this condition, let alone strive to normalise it by educating the masses. There had never been enough discourse around what sexual dysfunctions were and how people lived with them.
Wellington-based pelvic floor physiotherapist Liz Childs sees around 120 patients a fortnight, half of whom have tight muscles, and a notable portion of them having vaginismus.
Liz tells me that causes of vaginismus include anxiety, holding stress in your diaphragm, breathing pattern disorders, and fear of penetration. The onset of vaginismus can also be triggered by past trauma, with the body developing tightness as a protective mechanism from both physical and psychological pain.
While the condition is fairly common, the lack of awareness around it means the age at which women are diagnosed varies. Many spend years suffering in silence, assuming the pain they experience during intercourse is just their lot in life. Some of Liz’s patients had been told by GPs to “have a glass of wine before sex”, perpetuating the misconception that this was a surface level issue attributed to nerves.
Another misconception about vaginismus is that it is untreatable. Whilst alcohol isn’t the answer in this scenario, treatments for vaginismus include: breathing and relaxation exercises, posture improvement, medication, and psychotherapy.
The most well known treatment is dilator therapy, which focuses on desensitisation. Vaginal dilators are essentially the unerotic cousin of the dildo. They’re cylindrical instruments, often made of plastic or rubber, that come in various sizes and train the pelvic floor muscles to relax when something is inserted into the vagina.
You begin with the smallest dilator, which is usually the width of a finger. Once you become comfortable with inserting it, you move on to the next size up… eventually conquering the penis-sized dilator.
But dilatory therapy is uncomfortable, highly not-sexy and degrading. It feels bizarre that I have to actively train my muscles to behave the way they’re supposed to, just so I can someday fulfil my biological purpose of procreation. It’s like everyone around me can cartwheel to their heart’s content, while I can barely do a headstand.
Penetrative vaginal sex is the most accepted form of sex in our society, so vaginismus can become a cause for insecurity. Letting a guy know he can't stick it in you can be awkward, offensive or hurtful.
Vaginismus can be the difference between whether or not someone commits to an exclusive relationship with you. One night stands can turn sour when the other party has assumed you’re going ‘all the way’—whatever that’s supposed to mean. In no way is this a woman’s fault, but we’re the ones left feeling defective.
Liz has worked in the field of pelvic floor physiotherapy since 2002 and has noticed a large shift around the awareness of vaginismus. I myself was referred to Liz by my GP, who was familiar with vaginismus and wanted me to get properly diagnosed.
However, Liz now sees more self referrals, meaning that more women are confidently self diagnosing. She partially attributes this de-stigmatisation to online communities, who encourage transparency by publicly sharing their experiences. “We also use [online resources] every day at our work” she says, explaining how she refers her patients to useful websites so they can further educate themselves.
As well as online information, I believe that for sex education to be comprehensive, it must include information about sexual dysfunctions like vaginismus. One of many gaps in our current sex-ed curriculum is the lack of knowledge around how to actually have sex. We explore STIs and how babies are made, but if the act of sex isn’t discussed, people will remain unaware of barriers that prevent them from having it.
It’s especially disappointing to see classes divided when teaching male or female-specific health, as students grow to only care for the issues relevant to their bodies. These gaps in knowledge become full-fleshed idiocy, when some people refuse to accept that tight muscles are a legitimate reason not to have penetrative sex.
Some of Liz’s past patients have brought their male partners to appointments, so a medical professional could confirm that their inability to have penetrative sex wasn’t because they “didn’t like him enough.” Liz said it proves helpful when partners understand the causes of vaginismus and how they can get involved in the treatments, as this prevented the condition from posing issues in their relationship.
I used to think I was weak for wanting to scream every time I tried inserting a tampon: that I wasn’t woman-enough to push through it. Being diagnosed and learning about treatment options helped me realise vaginismus didn’t have to be a permanent part of my life.
If you’re someone constantly experiencing pain, bottling it up could lead to bigger issues. Bodies are unique and beautiful but vaginismus isn’t a ~quirky~ flaw you should put up with. Get help because you and your body deserve the best.
Personally, I take no pleasure in divulging my condition to the world. The thought that there are people I don't know—or worse, those I might someday meet—who have learnt about my vaginismus through the University magazine terrifies me. But I didn’t write this for judgemental assholes or taboo-loving prudes.
This is for anyone who has felt afraid, ashamed, and angry because their body won’t listen to them. It's for everyone who walks around with undiagnosed conditions because they didn’t receive an adequate health education. It's for teenage me, who navigated this by herself because she didn’t know who to turn to.
Sexual dysfunction isn’t something we talk about enough. But I want you to know that it does not define you. Sex is for anyone who wants it
—people with vaginismus included.
Navigating the ins and outs of vaginismus is a reminder: you don’t have to stick it in to get it on.
For more information, visit:
www.pelvicphysio.co.nz or check out
@thevagnetwork on Instagram