As wondrous as sex can be, there are millions of women struggling with difficulty. A large portion of these women have a unique struggle – their bodies will not allow for comfortable sex due to a condition known as vaginismus or genito-pelvic pain/penetration disorder (GPPPD).
Common Symptoms of Vaginismus:
- Burning or stinging with tightness during sex
- Difficult or impossible penetration
- Entry pain – uncomfortable insertion of penis
- Unconsummated marriage
- Ongoing sexual discomfort or pain following childbirth, yeast/urinary infections, STDs, IC, hysterectomy, cancer and surgeries, rape, menopause, or other issues
- Ongoing sexual pain of unknown origin, with no apparent cause
- Difficulty inserting tampons or undergoing a pelvic/gynecological exam
- Spasms in other body muscle groups (legs, lower back, etc.) and/or halted breathing during attempt at intercourse
- Avoidance of sex due to pain and/or failure
Vaginismus can occur at any age, even after enjoying intercourse previously. As you would expect, the condition can have significant physical and emotional consequences for the women and couples faced with it, from the newlywed who is unable to consummate her marriage to the woman with late onset who feels forced to discontinue having sexual relations altogether due to ongoing tightness and discomfort.
Variations in the Experience of Vaginismus
- Vaginismus can be triggered in both younger and older women, in those with no sexual experience and those with years of experience. Not all women experience vaginismus the same way, and the extensiveness of vaginismus varies
- Some women are unable to insert anything at all
- Some women are able to insert a tampon and complete a gynecological exam, yet are unable to insert a penis
- Others are able to partially insert a penis, although the the process is very painful
- Some are able to fully insert a penis, but tightness and discomfort interrupt the normal progression from arousal through to orgasm and bring pain instead
- Some women are able to tolerate years of uncomfortable intercourse with gradually increasing pain and discomfort that eventually interrupts the sexual experience
- Women may also experience years of intermittent difficulty with entry or movement and have to constantly be on their guard to control and relax their pelvic area when it suddenly 'acts up'
Historically, information about vaginismus has been lacking, receiving little attention in the media or within the medical community. The lack of discussion is especially unfortunate because, unlike many disorders, vaginismus is treatable.
Vaginismus is a condition in which the muscles surrounding the vagina involuntarily tighten, interfering with intercourse and sometimes tampon insertion or gynecological exams. Most women become aware of the issue through the experience of pain during sex or failed attempts at sex. The vaginal muscles tighten, making penetration uncomfortable, acutely painful, or impossible. Furthermore, the symptoms of pain, burning, and impenetrability can sometimes be accompanied by spasms in other body muscle groups, and even halted breathing.
The frequency of this condition among women is largely speculative, with reported estimates ranging from 0.5% to 17%. The lack of an exact statistic is unsurprising, considering the hesitance on the part of many women to seek help, due to shame, embarrassment, and uncertainty. The DSM-5 (2013) states that the prevalence of vaginismus is unknown, but adds that approximately 15% of women in North America report recurrent pain during intercourse.
Both sexually experienced and inexperienced women can develop vaginismus:
How sexually INEXPERIENCED women encounter vaginismus
A woman may find that during her first attempt at sexual intercourse, full penile penetration seems physically impossible, despite repeated efforts. It can be almost as if there is no opening, or like there is a wall where the vaginal opening is supposed to be.
After such an episode, many women mistakenly wonder if they are physically abnormal. They may think their vagina is too small, their hymen is deformed and blocking the opening, or they have no vaginal opening at all. Such thoughts are understandable, given that the extent of vaginal muscle tightening can make it seem like the opening is unusually tiny or nonexistent.
Anatomical malformations capable of blocking intercourse are extremely rare. In fact, in unconsummated relationships where the problem is due to the female (not resulting from a male erection issue), vaginismus is the most common cause.
Sometimes there are early signs of primary vaginismus prior to first-time intercourse, such as:
- Difficulty inserting tampons – A woman cannot insert tampons, even after repeated, earnest attempts.
- Inability to complete internal vaginal examinations – A physician’s attempted speculum or finger insertion is difficult due to the constricted vaginal opening, which appears to be unusually small or tense. Physicians may also notice a patient reflexively tensing and pushing her body away upon being touched in this area.
Some women may wonder if there is partial penetration, but typically the tip of the penis is only pressing into the fleshy outer vulva area, not fully into the vaginal canal. Rarely can the couple complete significant penetration, and when they do it is with pain due to extreme vaginal tightness. Further attempts typically fail to achieve success, or they result in even greater discomfort.
How sexually EXPERIENCED women encounter vaginismus
Vaginismus often appears later in life – in women who previously had a perfectly normal sex life – causing ongoing sexual tightness, discomfort, or pain. The condition can arise from a wide-variety of triggers, such as subsequent to surgery, trauma, or hormonal changes such as menopause. Even if the possible triggering issue has been resolved, a woman may find she has ongoing tightness and cannot experience pain-free sexual intercourse as she once did.
In some, the discomfort comes on rather abruptly; for others, there may be years of tolerable sex punctuated by incidences of increasing pain. With episodes of painful intercourse, a woman begins to experience heightened anxiety about sex, since it no longer brings pleasure and, in fact, feels just the opposite. This often leads to avoidance, with sexual intimacy becoming less and less frequent. Unaddressed, continued discomfort and tension arising from secondary vaginismus causes these couples to eventually discontinue having sex altogether.
Untreated vaginismus can result in deterioration of a couple’s relationship, as the physical and emotional needs once met by sexual intimacy are no longer fulfilled. Sadly, disappointment and frustration over this issue can wear away at the very foundation of their partnership.