Thousands of women are experiencing painful sex without realizing why, or that their lady part problem is 100% treatable. Georgia Clark explains vaginismus: the sexual health dysfunction your GP doesn’t know about.
John Mellencamp spoke the thoughts many of you are having right now: sometimes love don’t feel like it should. But there’s nothing good about this hurt: Dyspareunia, (pronounced dis-par-you-knee-ah) which simply means pain during sex.
Dyspareunia will affect up to one-fifth of women worldwide at one stage in their life. And for many of us it’s not just painful – it’s confusing and scary. So it may come as a surprise the most common reason we experience painful sex is a treatable, muscular dysfunction.
Vaginismus is an involuntary tightening of the pelvic floor muscle, a hammock of muscles that sits between the pubic bone and the tailbone. This tightening occurs in anticipation of pain. In the same way you flinch to tighten muscles to avoid being hurt, your pelvic floor muscle will ‘flinch’, or tighten, if you expect sex to be painful. You don’t even know you’re doing it – and you can’t stop. The muscle stays in a permanent state of spasm and like any tight muscle, trigger points – taunt bands of muscle – form. When these trigger points are touched, they send pain signals to the brain. “That pain signal will tighten the muscle further, giving more trigger points,” explains Angela James, physiotherapist and vaginismus expert. “It’s a vicious cycle.”
Vaginismus is caused by an extraordinary amount of things. “It can be primary – in that the first experience of sex was painful, so there is an ongoing expectation it will be,” says Angela. “Or it can be stress, back pain, sexual abuse, body image issues, self-esteem – the list goes on.”
Treating the Problem
“It’s important to know vaginismus is a muscular dysfunction, like any other muscle in your body,” emphasizes Angela. “You’ve got control over it.” Treatment aims to release the muscle, and revolves around recognizing how to switch it on and more importantly, off. Angela also works with dilators to desensitize the vagina, and internal trigger point massage.
Get Warmed Up
Sex therapist Tanya Koens estimates that of all the young women who see her with experiences of painful sex, 50% of them simply aren’t turned on enough. If the flow from sexy thoughts, to kissing and touching, to heavy petting is rushed or ignored, the pelvic floor muscle will not being lubricated or relaxed enough to allow a penis to enter, and vaginismus can occur. She emphasizes the importance of women calling the shots on Penetration, Position and Pace. “By controlling these, you have greater chance of enjoying sex,” she says.
If Pain Persists?
Vaginismus is common, but not the only reason why you might have started experiencing painful sex – it could be everything from infection to problems with your reproductive organs. If pain persists, see a GP, but be warmed, both Tanya and Angela agree GPs commonly aren’t aware of vaginismus and can lead patients to believe “it’s all in their head”. Madeline* had her vaginismus misdiagnosed by GP, and suffered painful sex for seven years after symptoms began at age 17. “It had a huge affect on my self esteem,” she says. “I thought it was my body telling me I didn’t really love my boyfriend.” Now seeing a physio and a therapist, Madeline says her vaginismus is improving. “I feel I will finally get there and have a normal sex life.”
ASERT: the Australian Society of Sex Educators, Researchers and Therapists PACFA: Psychotherapy and Counselling Federation of Australia.
See vaginismus.com, sydneytherapist.com and ajphysio.com.au for more info.
- Name changed.