When Having A Tight Pussy Isn't Enjoyable
In my experience as a heterosexual, cisgender woman, having a "tight" vagina in sexual relationships is the golden standard for being an “ideal” sexual partner. The admiration of the tight pussy is a problematic concept that reduces heterosexual, cisgender women to orifices of pleasure for intimate partners. Yet, we don't talk about whether or not it's possible that a pussy can be so tight that it makes sex unenjoyable for women and even makes penetrative sex agonizingly painful and a traumatic experience.
Dyspareunia, also known as painful sex, impacts about 75% of women during their lifetime, according to a research study conducted by the American College of Obstetricians and Gynecologists (ACOG). Various causes can lead to dyspareunia. The conditions can be physical or mental, or a combination. One of the leading causes of painful sex or dyspareunia in women is vaginismus. The Library of National Medicine reports that about 1 to 7% of women worldwide suffer from vaginismus. In fact, many healthcare providers believe vaginismus is a relatively common female sexual dysfunction disorder. Unfortunately, vaginismus potentially goes underreported due to taboo stigmatization around female sexuality and anatomy.
Even though vaginismus is a common female sexual dysfunction, like many reproductive and sexual health conditions that impact women, this chronic pain condition is rarely discussed. More than likely, vaginismus is underdiagnosed due to the lack of research, knowledge, and information on sexual dysfunction and women not understanding their bodies nor feeling comfortable discussing sexual issues with healthcare providers or others around them. Sex shouldn't be unbearably painful, it should be pleasurable and exciting, and you have the ability to enjoy sex with a vaginismus diagnosis.
What Is Vaginismus?
Vaginismus is one of the conditions incorporated into a significant condition called Genito-pelvic pain/penetration disorder (GPPPD). It's a painful female sexual dysfunction, a common diagnosis of women with sexual interest disorders or low libidos. While women experiencing vaginismus can still get aroused, the uncomfortable medical condition can make penetration difficult or sometimes impossible.
Vaginismus makes penetration of a penis, finger, sex toys, tampons, medical instruments, or any devices painful because of the involuntary, unconscious, and automatic tensing or contracting of the muscles in or around the vagina. Vaginismus involves a muscle spasm, sometimes compared to the likeness of a Charley horse, within the pelvic floor muscles. The tightening of the vaginal muscles is an uncontrollable reflex to the involuntary pelvic floor muscle spasms. Due to the intensity of the muscle spasms, the vaginal muscles become too taut, causing intolerable vaginal penetration and vulvar pain.
The Different Types Of Vaginismus:
Vaginismus can be classified into two types: primary and secondary. Vaginismus symptoms are often classified into global or situational vaginismus upon diagnosis.
Primary Vaginismus is when no kind of vaginal penetration has ever been successfully achieved.
Secondary Vaginismus is when vaginal penetration has been achieved but is no longer possible due to environmental factors like gynecological surgeries, physical injury, mental or physical trauma, or radiation.
Global vs. Situational Vaginismus determines the occurrence of the vaginismus and can happen with both types. Global vaginismus is the classification of a non-discriminatory response to any vaginal penetration. In contrast, situational vaginismus is the classification of the response to specific kinds of penetration but not all types.
Who Is Most At-Risk For Vaginismus:
Individuals most at-risk for vaginismus are anyone with a vulva and vagina; it can happen to an individual at any stage in their life. It's possible to be someone who's always experienced discomfort or intense pain during vaginal penetration, or you could have never experienced discomfort or painful vaginal penetration and begin to experience it at a particular stage(s) of life.
The Causes Of Vaginismus
In The Intercourse Discourse Interview with Dr. Kenael Segal, PT, DPT, Pelvic Health Physical Therapist says, "The causes of vaginismus are unknown. But I believe it's a bodily response to a past traumatic experience(s), and the body is trying to protect itself from experiencing that same trauma(s) again." Therefore, it's not always clear what causes vaginismus. Many medical professionals speculate that since vaginismus is the body's automatic and unconscious reaction to the fear of some or all vaginal penetration that sexual dysfunction for many is onset by physical and emotional triggers.
Vaginismus has been linked to individuals that have experienced physical stressors like childbirth, endometriosis, gynecological surgeries, bodily injury, and vaginal or pelvic infections. Mental stressors and social factors have also been linked to vaginismus, like anxiety, depression, past sexual trauma, intimate partner violence, sexual shame or guilt perceptions, and traumatic life events. It's important to understand that several factors can cause vaginismus, and it's crucial to work through these triggers with your healthcare team once they've been identified to manage vaginismus better.
The Signs And Symptoms Of Vaginismus
Vaginismus symptoms can present themselves during adolescence at the start of an individual's menstrual cycle when they notice pain with tampon insertion, during a person's late teen years or early adulthood when having penetrative sex for the first time or a women's wellness pelvic exam, during or after pregnancy, or later in life during their menopausal years after never having any issues with penetration.
The most prevalent sign and symptom of vaginismus is dyspareunia or painful sexual intercourse. However, vaginismus signs and symptoms aren't limited to painful sexual intercourse.
The following symptoms listed below could be signs of vaginismus:
Difficult, painful, discomforting, or feeling like there's a wall being hit with the insertion of medical instruments, sex toys, genitalia, or fingers.
Burning, pain, and discomfort at the vaginal opening
A feeling of pressure in the vagina
Dysuria or painful urination
Dyschezia or painful bowel movements
Vulvar pain or soreness
Vaginismus can be a harrowing, frustrating, and upsetting experience that heavily impacts your quality of life, but with proper medical care and accurate diagnosis, it can be effectively treated.
The Vaginismus Diagnosis Process
A vaginismus diagnosis starts with discussing your symptoms and a verbal or written assessment of your medical and sexual history with your healthcare provider. During the medical visit, your healthcare provider may want to conduct an internal and external pelvic examination to rule out any other underlying conditions causing these symptoms, like signs of infection or scarring. A pelvic exam will not only rule out other possible medical issues but also confirm the presence of muscle spasms, which will help the healthcare provider determine if it's indeed vaginismus.
Vaginismus can make a pelvic examination painful, so your healthcare provider may apply a topical numbing cream to the outside of the vagina or practice relaxation exercises with you to make the process more comfortable. However, Dr. Segal, PT, DPT, says a pelvic exam is unnecessary to begin the treatment plan or diagnosis for vaginismus. She has obtained a diagnosis of vaginismus from a patients’ medical, sexual, and family history, coupled with a discussion of their pelvic pain symptoms. Dr. Kenael Segal expresses in her interview about vaginismus that chronic and persistent pelvic pain can often be trauma related. Hence, working with a healthcare provider with a trauma-informed lens helps facilitate recovery by ensuring they’re treating the root of the issue and making individuals feel safe and secure during the session and in their bodies. Therefore, you can be diagnosed and treated for vaginismus without the fear and pain that sometimes can be accompanied by a pelvic examination.
Since there can be many causes of pelvic pain or painful sexual intercourse, vaginismus is often misdiagnosed not only because of social stigma around female sexuality and lack of research but also because if there is no physical reason for the vaginal muscles to tighten and contract it can make it difficult for doctors to find a cause for these symptoms and pinpoint whether vaginismus is the true culprit.
Vaginismus Treatment Options
The excellent news about receiving a vaginismus diagnosis is that it's a treatable and curable medical condition. The currently available treatment options for vaginismus focus on getting rid of or at least managing the pain and pelvic floor dysfunction associated with the condition. Vaginismus treatments focus on eliminating the physical response while lessening the negative psychological factors associated with vaginal penetration. Thus, Dr. Segal, PT, DPT, and other medical professionals will suggest utilizing multiple treatment options simultaneously for the best outcome.
The following available vaginismus treatment options are listed below:
Pelvic Floor Physical Therapy: In pelvic floor physical therapy, a physical therapist will create a tailored treatment plan to help best resolve your vaginismus diagnosis. The physical therapist will teach you exercises and techniques to relax and stretch your pelvic floor muscles to alleviate vaginismus symptoms and pelvic floor dysfunction. The treatment plan will often include progressive desensitization, the most effective pelvic floor therapy for vaginismus. Progressive desensitization involves people using their fingers, vaginal dilators, or pelvic wands to gradually become more comfortable with vaginal touching and, eventually, vaginal penetration. These exercises help people regain control of their vaginal muscles. A pelvic health physical therapist will provide you with pelvic floor control exercises, stretches to help pelvic pain, and breathwork individuals can do at home to help alleviate anxiety and pain around vaginal penetration.
Sex Therapy And Trauma Counseling: Sex therapists can provide individuals with the needed sexual health education that involves your sexual anatomy and sexual response cycle. This sex education helps individuals with vaginismus better understand their pain and its impact on their pelvic floor muscles. Trauma counseling, cognitive behavior therapy (CPT), or sex therapy can help improve vaginismus patients' emotions around their bodies and sex lives. Talk therapy often helps those with vaginismus conditions triggered by fear or mental health challenges like anxiety, PTSD, or depression. Therapists and counselors can also provide meditation and relaxation and even conduct hypnosis to help you become more comfortable with vaginal penetration.
Topical Ointments And Vaginal Suppositories: Topical lidocaine, compounded creams, or vaginal valium (diazepam) suppositories can potentially relieve pelvic pain for about eight hours, which can help with the painful muscle spasms and aid in the completion of progressive desensitization.
Botox: Botox has become a new and innovative procedure to treat vaginismus. While research shows that it potentially improves vaginismus symptoms, more research and trials are necessary to verify this conclusion.
Pulsed Radiofrequency (PRF): Pulsed Radiofrequency is a nerve pain or localized pain in the body caused by irritation, malfunction of a nerve, or pain system sensitization. A pain management doctor performs this nerve pain treatment in an operating room, and the therapy requires light sedation. PRF is a relatively new treatment, and limited research has shown potential for vaginismus improvement utilizing this pain management therapy.
The best way to tackle a vaginismus diagnosis is with the help of a medical team that consists of a mental health or sex therapist, pelvic health physical therapist, primary care physician, and a gynecologist that specializes in sexual health and dysfunction because vaginismus is a multifaceted condition. These various treatments and healthcare professionals play an integral role in curing vaginismus, and with the right treatment plan, medical professionals have seen above a 90% success rate with vaginismus patients.
Vaginismus Impacts Your Mental Health & Relationships
Vaginismus is a medical condition that disrupts more than your physical well-being. Our body and mind are connected, and our physical, sexual, and mental health are interconnected, and if one of them gets thrown off, it upsets the balance of our overall health and quality of life. Therefore, living with Vaginismus isn't limited to physical pain but emotional distress and a disruption of our intimate and sexual relationships.
Negative Mental Health Impact:
Vaginismus can amplify an individual's mental health issues like depression and anxiety. A person dealing with vaginismus may become more anxious around sexual activity, gynecological visits, or the thought of utilizing menstrual care products. Depression can set in because of the impact that vaginismus has of living in a constant state of chronic vulvar and pelvic pain which can cause you to lose interest in activities you once found enjoyable or the ability to go out and experience life with friends and family. Dealing with sexual dysfunction heavily impacts sexual confidence, self-esteem, and self-image, making you feel less desirable because of your inability to satisfy yourself or your intimate partner(s) entirely. Also, vaginismus can cause you to develop a negative relationship with your body because you feel like it's failing you by not working properly or in a "normalcy" you were once accustomed to.
Disrupts Relationship Harmony:
Physical intimacy and sex can be integral to relationship satisfaction and connection. Therefore, sexual dysfunction can lower your libido and sexual desires. The absence of sex can cause a rift in partnerships and make your partner(s) feel neglected and starved for affection. Dr. Kenael Segal, PT, DPT, shared that she's heard stories of divorces and breakups from vaginismus patients because of their inability to engage in sexual intercourse and overcome mismatched libidos.
Indirect Impact On Fertility:
Vaginismus doesn't directly impact your fertility or ability to get pregnant. However, pelvic pain can indirectly affect fertility and conception due to the inability to have penetrative sex with your partner(s). The infrequency of sexual intercourse due to vaginismus can make it difficult to conceive.
The best way to combat mental health and relationship issues involving vaginismus is to acknowledge that you may be dealing with sexual dysfunction and to seek help from a medical professional. Vaginismus is a psychosomatic medical condition, so it's beneficial to seek the help of a mental health professional to gain resolution with emotional distress and relationship concerns.
Tips For Navigating Vaginismus To Have A Thriving Sex Life
Living with Vaginismus doesn't mean it's a death sentence to your sex life. Pelvic pain is manageable and treatable. While working through alleviating the sexual dysfunction, here are five tips to help you still enjoy a healthy and happy sex life:
1. Engage In Sex Acts That Don't Involve Penetration: Physical intimacy to help grow and maintain connection goes beyond penetrative sex. You can engage in mutual masturbation like hand jobs and stimulation of the clitoris and other pleasure points of the vulva that aren't painful. Partners can engage in the five gears of touch and learn new and exciting erogenous zones of each other. You can use toys like fleshlights or clitoral stimulators (if orgasms don't cause pain) to achieve a sexual climax. If vaginal penetration is the source of pain, explore anal play and focus on oral.
2. Bring Your Partner Into Your Progressive Desensitization Therapy: Some pelvic health physical therapists allow you to bring your partner(s) into a session to help support you on your journey. You can take what you learn in the session about using dilators, wands, and fingers to help stretch the muscles for vaginal penetration and incorporate your partner(s) into the exercises at home to help build trust and connection to help remove the anxiety around sexual intercourse. When using vaginal dilators before sexual intercourse, have your partner(s) insert it for you, thrust it, and even opt for a vibrating vaginal dilator to make the exercises more pleasurable and get you in the mood for penetrative sex.
3. Have Open and Transparent Conversations With Intimate Partners: Open and transparent communication is vital to any romantic and intimate relationship. Communication becomes even more crucial when sexual dysfunction arises. Through couples or sex therapy or setting a time in your schedule that works for both of you, discuss your feelings, needs, and desires around your sex life and look for ways to lean on each other and improve the situation.
4. Spend More Time On Foreplay: On average, women need about 18 to 20 minutes of foreplay to become fully aroused to have comfortable and pleasant penetrative sex. So, don't neglect foreplay because the more time spent getting her aroused and lubricated allows the vagina's titillated walls to expand to make penetration an endurable and positive experience.
5. Explore Different Sex Positions: Exploring and changing sex positions during penetrative sex can drastically change the comfort and enjoyment of vaginal intercourse. Depending on the localization of the muscle spasms, finding sex positions that may not be deeply penetrative can help make the shared sexual experience pleasurable.
Defeating Vaginismus And Rediscovering Pleasure
Dr. Segal, PT, DPT, expresses her sentiments best in The Intercourse Discourse interview when she states, "Healing from vaginismus doesn't happen in one pelvic floor physical therapy session. It's a process because it takes time to heal the body and the mind. You must be patient, understand that change doesn't happen overnight, and be kind to yourself by celebrating progress." So, if you are trying to navigate vaginismus, remind yourself that patience, time, and giving yourself grace is essential to your healing process.
Remember that you are not alone on this journey. Your worth, desires, and pleasure are valid and deserving on your vaginismus healing journey. Every step you take towards understanding your body, communicating your needs, and seeking support is a triumph in itself. Embrace self-compassion and patience as you navigate this path; healing takes time. Surround yourself with understanding and loving individuals who will stand by your side, providing the warmth and encouragement you deserve. Celebrate the progress, no matter how small, and let it fuel your determination to create a fulfilling and joyful sex life. You are stronger than any obstacle, and your resilience will guide you toward a future where pleasure knows no boundaries. Keep shining your light and embracing the beautiful complexity of your being. Remember, you have the power to reclaim your sexuality and experience intimacy on your own terms. The vaginismus journey may be challenging, but with unwavering determination, love, and support, you will discover a newfound freedom and delight in sexual pleasure.
Vaginismus isn’t something that you have to navigate alone, and healing is possible. If you want to learn more about vaginismus from pelvic health physical therapist Dr. Kenael Segal, PT, DPT, then watch The Intercourse Discourse Interview, Is Your Tensions No Longer Sexy? Therefore, part of Lala's Bedtime Tales mission is to provide a safe space and judgment-free zone to educate yourself on sexual health & wellness. The Sexual Health & Wellness corner will have monthly articles dedicated to continuous education on living a positive and sexually healthy lifestyle. Subscribe to Lala's Bedtime Tales Newsletter and follow @LalasBedtimeTales on social media to never miss any sexual education to help you live the healthiest life possible. Also, check out Lala's Bedtime Tales Podcast and Lala's Oh So Exclusive Patreon account for even more content! If you’re browsing for sexy pleasure products or cute giftable items, then check out Lala’s Pleasure Shop.
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