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Thinking about Vaginismus

I recently asked on my LinkedIn page whether people had heard of Vaginismus. 33% of those who responded had no idea what it was at all while another 13% had heard of it but weren't sure what it really was. The same week I had conversations with women who had been experiencing vaginismus for years but no-one had given it a name or explained to them why or how they had developed this most painful and troublesome of difficulties.

Vaginismus is the term used to describe the "involuntary contraction / tightening of the vagina which prevents pentetration of any kind. Basically, the walls of the vagina clamp shut. Sometimes this can occur as a one off event. But for many this becomes a pattern that is hard to break. It means difficulties with intercourse, issues with conceiving, pain when masturbating using toys, pain when using tampons, problems with smear tests etc. It can also mean a sense that your body is broken, that you are failing and all kinds of other negative and self critical thoughts. The worldwide incidence of vaginismus is thought to range from 1-17%.

My first memory of hearing about vaginismus was as a teenager in a magazine (might have been Mizz, which I loved much to my mum's disgust), that ran an article on sexual difficulties. For the next 20 or so years as I made my way through various jobs in differing services (predominantly working with people with difficulties relating to trauma and relationships), vaginismus seemed to fade into the background. I don't remember any other professionals talking about it, I don't recall any of the people I worked with mentioning it and sadly I don't ever remember asking about it.

Fast forward to the last few years and my passion for all things sex related and all things trauma related combined with the freedom of working for myself dragged vaginismus to the front of my brain again. The majority of training around vaginismus seemed to focus around relaxation and using dilators which seemed counter-intuitive to my standard therapy approach of starting at the root of the issue and moving forward from there. The focus on symptom management as the whole answer frustrated me (as it always has and probably always will) so I switched my attention to the approaches that I use as standard in my therapy work and how to translate the therapies I use ( such as Compassion Focused Therapy and Eye Movement Desensitisation and Reprocessing, EMDR Therapy) to help those who experience Vaginismus.

When I work with those who experience vaginismus (and their partners) my priority is to take a really thorough history and to help those involved make sense of how and why the vaginismus occurs. Vaginismus can occur at any point, sometimes it seems to have been present forever whilst for other people it develops in later life (often as a result of a traumatic or difficult life experiences). Following on from this we figure out the best treatment approach. We may focus on working through trauma (eg sexual trauma or birth trauma) using EMDR. There may be a focus on psycho-education (understanding how our bodies respond sexually) and there may be a focus on relationship and communication issues. I work in a way that tailors the therapy to fit your needs rather than expecting you to fit into a pre-determined way of working. Your goal's might be around sexual pleasure or they may be focused around physical health care. Or they may be completely unique to you. Your consent in the process is key.

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