Show your vagina some love – everything you need to know about Vaginismus
May is pelvic pain awareness month. There is a condition called Vaginismus which very much fits this label of pelvic pain. Although vaginismus affects around 1 in 10 women, it is likely that you have not heard of this condition.
And it is very probable that the statistics are even higher than this, due to low awareness of this condition.
What is Vaginismus?
The muscles of the pelvic floor control the opening and closing of the vagina, urethra and anus. When the pelvic floor muscles are weak, we may not manage strong, quick or effective closing. This has a direct relationship with our continence.
There are also muscles inside the vaginal opening. You can feel them flex when squeezing a penis during penetrative sex. Or perhaps you may feel them flex or spasm during orgasm. You can even try flexing them right now and no one will even know!
Vaginismus is when these muscles involuntarily contract. And it is difficult to relax them. (Vulvodynia is when the pain is in and around the vulva – and a blog for another day). This can mean that trying to insert something into your vagina – be it a penis, tampon or toy, is both difficult and painful. For some women, this involuntary lock can mean that nothing can go in. Not even the tip of your smallest finger.
The symptoms don’t stop there.
An overtight pelvic floor (or when it is unable to relax) behaves much like a weak pelvic floor. It is unable to respond to varying pressures. It cannot switch on if it is already on. And being on all the time can weaken the muscle.
Having a tight pelvic floor can also cause leaking.
What causes vaginismus?
The causes of vaginismus are complex. It is not only a physical condition (of muscles clamping on involuntarily) but also a psychological condition as well.
We can’t discard the relationship between how women are taught to think about their sexual organs and involuntary physical responses. Even the language of vagina, vulva, and clitoris are often all lumped in together as “private parts” or just vagina.
- The relationship between mind and body.
It is no coincidence that Ireland and South America have the highest reported instances of vaginismus. They are also a population raised with a strong conservative faith. Conservative faiths of all denominations often discourage women not to look or touch themselves and may view their sexual anatomy as dirty.
This indoctrination about viewing your sexual organs or sexual pleasure as dirty can be at odds with relaxing and enjoying sex.
- Response to sexual trauma or birth trauma
Vaginismus can also be a result of previous sexual trauma. And consensual sex with a loving partner may trigger past experiences and cause an involuntary lockdown. Similarly, a traumatic birth can also change the emotional response relationship with sexual pleasure.
- Response to pain
Vaginismus is not the only pelvic pain. Common urine infection or a good case of thrush can stop you in your tracks. The pain is constant until the infection is dealt with. Unfortunately, antibiotics are given to clear the infection, and also clear out the good bacteria. And often women experience an ongoing bout of these as the body seeks homeostasis.
When I worked as a personal trainer, I trained a woman who was a ballet dancer who had experienced years of thrush from sweaty ballet tights and was now dealing with debilitating vaginismus. She told me the thrush cream had thinned the skin around her vulva and vagina opening so much, that sometimes, just walking caused this sensitive skin to split and bleed.
- Response to stress
I personally know this one. Some people grind their teeth at night as an involuntary reaction to stress. I clench my butt. I don’t even know that I am doing it until I check-in and remind myself to relax. I was experiencing personal stress and started to leak. Now as a personal trainer who has championed the importance of pelvic floor and not putting up with leaking, I was at a loss as to why.
I stepped up my pelvic floor routine and nothing improved, in fact it was getting worse. I was leaking simply from going for a walk! In response, I started to squeeze my pelvic floor muscles even more. This shortened my stride and instead of enjoying my activity, I was horrified by what my body was doing.
I have been working with pelvic health physiotherapists for the whole existence of my professional life in the fitness industry. Working collaboratively with pelvic health physios was the business model that I won awards and I franchised my business, mishfit® on.
So not only did I know the best in the business. But many of them, I now counted as friends.
Which one of your friends would you choose to check your pelvic floor?
I chose Jen from Clifton Hill Physiotherapy, whom I knew and trusted immensely. Although I knew about the hypertonic pelvic floor, I had failed to recognise the symptoms. Jen did an internal examination, while we chatted about what else was going on. I admitted to some of my external stresses, and she told me that my pelvic floor muscles were now so tight, that I was probably unable to distinguish them as anything other than normal.
She explained that she could release them internally. Much like releasing any tight muscle with manipulation. I literally felt the muscle release beneath her fingertips.
I count myself as fortunate, that I sought help at the early stages of leaking to realise the cause. If I padded up and ignored it, it is possible that this inability to relax the muscles could have moved into the realm of vaginismus. Then it would have been highly improbable that Jen couldn’t release the muscles from the inside.
And not being able to have sex would have completely sucked too.
Can Vaginismus be fixed?
Like with all conditions, early awareness and treatment are paramount. Unfortunately, there is still plenty of good old fashioned medical bias as this condition, like many that affect women is largely omitted in general medical training.
It is not uncommon for women seeking help for painful sex, to be told to have a glass of wine and “just relax” more.
Not helpful as this advice may trigger a shame response, that leads us to believe that we are somehow at fault. Or just plain faulty.
Once you have the right diagnosis, then you may be given a series of dilators to help the body slowly adapt to the change, the pressure of insertion.
Friends in all the right places
Yes, diagnosis is key.
Then one of the places I recommend to help is a really, really good sexuality store. My personal favourite is Passionfruit – the Sensuality Shop in Richmond, Melbourne.
Michelle (great name) the owner and I have become great friends over the years. She is knowledgeable, empathetic and has a fabulous infectious smile. Michelle can make discussions about anything from dildos to sexual dysfunction (and there is a LOT in between) as natural as talking about coffee.
Michelle writes excellent blogs around all manner of things – and HERE is a great one on products that can help painful sex.
Oh, and here is ANOTHER ONE, that I got to share some insights into!
Show your vulva and vagina some love.
- If you experience any sort of pain or leaking – go and seek help and diagnosis. Dealing with a little bit of pain or a little bit of leaking is not only cost-effective but emotionally effective than dealing with vaginismus or vulvodynia.
- After a workout, don’t sit around in your sweaty gear – change into dry clothes rather than letting them dry on you.
- Your vulva and vagina are amazing self-cleaning machines with their own system going on. A gentle or mild soap is enough. Start to familiarise yourself with your smell. It will change over the month and maybe the first indication of a change or infection.
- Use a good lube. Especially in perimenopause when your natural lubricant may go walkabout. This may feel good for other times, not just sexy times!
- Find a vaginismus support group. You are not alone and finding others who understand and relate can really help.
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