‘Breaking down the Walls’ of Vaginismus – Part I: What is it?
If you are struggling with painful sex or have not had success with penetrative intercourse but would like to, then you may want to learn about, and consider if the condition of vaginismus is at play.
What is Vaginismus?
Vaginismus is a pelvic pain condition that is characterized by recurrent or persistent spasm of the vaginal musculature that interferes with vaginal penetration. As a result, vaginismus will often present with phobic avoidance by the person affected as well as anticipation and fear of pain with attempts at penetration 1. As you can imagine, this can be quite distressing to the individual experiencing these symptoms and it can significantly affect their quality of life, more specifically their personal relationships.
If you are experiencing repeated pain with intercourse and can’t figure out why, be sure to speak to your family doctor, pelvic physiotherapist or gynecologist to rule out other medical issues that could potentially be at play. If other differential diagnoses are ruled out, then vaginismus may be a possible reason for your pain. Commonly reported symptoms from clients struggling with vaginismus may include:
-having difficulty or pain with tampon insertion
-have unsuccessful or very painful PAP exams or other internal vaginal medical tests
-have not had success with penetrative intercourse
The good thing is, there are excellent treatment options and recommendations that can help you overcome vaginismus. But before we talk about that, let’s chat a bit about pain.
The International Association for the Study of Pain (IASP) revised their definition of pain in July 2020 to ‘An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage’ 2.
We can see that this definition alludes to the fact that pain is a ‘sensory AND emotional experience’. This experience will differ from one person to the next and is often highly influenced by different peoples’ personal experiences. For example, someone who has had a history of many falls onto their buttocks and has increased sensitivity in the pelvic region, may find an ongoing discomfort in the area much more disturbing and painful than someone who has not had a history of injury to the area.
A history of injury could potentially bring up some negative emotions with respect to the particular area involved. If negative emotions arise, this could influence the pain that is experienced. Studies have shown that higher pain intensity is associated with less joy, less laughter and higher negative affect 3.
The second part of the definition of pain is also quite important as it speaks to the idea of pain being a result of either ‘actual OR potential tissue damage’. This means that a person may not necessarily have actual tissue damage for a them to experience pain. Just the threat or thought of potential tissue damage, alone can bring on pain symptoms. Isn’t this fascinating!?? Your body and mind will attempt to protect you (by manifesting pain), if it senses that it is in danger or if it doesn’t feel safe - even if there is no injury present.
It may not be what you are looking to hear, but at the same time, it can also help explain some of the reasons why a person may struggle with persistent pelvic pain or pain with intercourse. A person that has a history of continuous struggle and negative experiences with sex will more likely experience pain with ongoing attempts, even if there is no tissue damage involved. The repeated attempts at penetration without success thus trains our nervous system to automatically respond in ways to protect the individual from this ‘negatively perceived’ activity. How does it do this? By protecting the body (and vagina), by outputting more pain and thus the muscles go into more tension and spasm.
As you can see this can then become a negative cycle of pain <–> tension <–> more stress and anxiety <–> which then brings on more pain. And this can go on and on for some people. But there is some light at the end of this ongoing cycle because we all have the power to break this cycle and make our way towards pain-free intercourse.
Don't miss Part II of this blog – Treating Vaginismus. We'll tell you about important factors to consider and how to manage this condition. Sign up for our email list today and be notified when it releases.
- Ishak and Tobia, Reprod Sys Sexual Disorders 2013, 2:2
- Dunbar et al. Proc R Soc B 2011;1373