Vaginas. They can be serious SOBs sometimes and BFFs other times. If you have vaginismus, you probably are leaning towards the former.
“Uhh, vaginismus? That doesn’t sound good.” It’s definitely not fun.
What is it?
To sum it up, Dr. Sherry A. Ross, Women’s Health Expert and Author of she-ology. The Definitive Guide to Women’s Intimate Health. Period., says, “Vaginismus is a condition where the muscles of the vagina contract involuntarily, tighten or spasm causing vaginal pain, sexual discomfort, burning and penetration problems. It’s a complicated medical condition that is both emotionally challenging and physically painful.”
Symptoms vary from woman to woman, but Dr. Sherry says they can include burning, stinging, itching, throbbing, swelling and soreness. Not exactly words you want to use when describing how your vagina feels.
“For an added one-two punch, these symptoms are chronic, come without warning and last a variable amount of time,” Dr. Sherry says. “Exercise, tampon insertion, the ability to wear jeans, sexual intercourse and various other everyday activities can become impossible with the onset of this condition.”
Related: UTIs + Sex: Everything You Need to Know
How do you know if you have it?
Usually, young women realize they have these symptoms the first time they try inserting a tampon when they go in a for a pelvic exam or the first time they try any kind of intercourse.
Mackenzie* remembers pulling out tampons was painful but wasn’t too concerned until she tried having sex for the first time.
“I knew it was supposed to hurt a bit the first time, but this was so bad I wanted to cry. After a few more attempts, my partner and I knew something was wrong,” Mackenzie says. “I went to my annual a few months later and mentioned it. I had never even heard of vaginismus or any other issue like it.”
For her, openly talking about vagina pain wasn’t considered “normal,” but confiding in a doctor gave her a medical explanation.
“While I didn’t love the fact that I suffered from this condition, it was still nice to know that this was something other women went through and that there were ways to make it better,” Mackenzie said.
Unfortunately, a lot of women go undiagnosed for years or never get diagnosed at all because of the stigma around vaginas.
Megan* noticed the pain when she was 14 and physically couldn’t insert a tampon, something all her friends seemed to have little to no issue doing. However, she wasn’t diagnosed with vaginismus until she was 21.
“The first gynecologist I saw probably wasn’t familiar with vaginismus because we discussed a lot of other reasons why I might be having trouble using a tampon, but vaginismus was never brought up. One doctor even tried to prescribe me lidocaine,” she says. “It wasn’t until I saw my current doctor that she finally explained what was going on, which was such a relief.”
Megan is far from alone though. “The incidence of vaginismus ranges from five to 42 percent. This wide range is due to women not openly discussing symptoms related to vaginismus especially as it relates to sexual dysfunction,” Dr. Sherry says. “Talking about sexual problems or topics involving the vagina is not easy for women or health care providers to bring up.”
Vaginismus might suck, but not realizing what’s even going on sucks even more.
What can be done about it?
Despite how severe it sounds, vaginismus is treatable.
“Treatment involves cognitive and behavioral psychotherapy also known as desensitization,” says Dr. Sherry. “Desensitization therapy teaches women to control pelvic muscle tone and relaxation. Kegel exercises and using vaginal dilators help women control their pelvic floor muscles.”
“Other treatment options include sex therapy, progressive relaxation, electromyography, biofeedback, hypnotherapy and use of benzodiazepines and botulinum [Botox] injections,” Dr. Sherry says.
Dr. Sherry says simpler pain management options include icepacks, cool gel packs or Vaseline for temporary relief, or oral medication, including antidepressants such as amtripyline, nortripylline and Prozac and anticonvulsants such as gabapentin and carbamazepine. Lara Parker, an editor at Buzzfeed who writes openly about her vaginal problems, uses CBD oil, a form of medical cannabis, to manage the pain.
That long list of options is intimidating, but Dr. Sherry says treatment plans have to be individualized for each patient. It might take several doctor visits and trial and error to find the right combination of treatment. Talk to your doctor to figure out if/what medication is for you.
Luckily, there are some smaller things you can do to minimize irritation. “During this time, general self-care of the vulva is vital, as is true when dealing with any problems down south,” Dr. Sherry says.
Dr. Sherry’s Self-Care Tips:
- Rinse and pat dry the vulva after urination. Use warm water.
- Avoid rubbing the vulva, especially when bathing.
- Avoid perfumed soap or scented toilet paper.
- Avoid douching, feminine sprays or talcum powder.
- Avoid pads or tampons that contain deodorant or plastic coating.
- Avoid pantyhose, unless it has a cotton crotch.
- Avoid tight-fitting pants or underwear.
- Use adequate lubrication during intercourse.
It might take weeks or months, but many women do see results. Lara, Mackenzie and Megan attribute a lot of their progress to physical therapy. Doctors can only do so much, though. Women have to take ownership of their bodies and commit to treatment to see results.
“Both conditions can be cured depending on a woman’s motivation and determination not to allow this condition to run her sexual and everyday life,” Dr. Sherry says. “It may be challenging to treat but it can be done.”
What about the mental stress?
While vaginismus is in no way anybody’s fault, young women can still feel very self-conscious about the condition.
Even with her progress, Mackenzie says her first break-up impacted her a lot. “I felt hopeless about the future of my relationships,” Mackenzie says. “While I understand now that there are so many more important things to consider, I’d be lying if I said I wasn’t a little self-conscious.”
Unfortunately, a physical issue like vaginismus comes with a host of psychological concerns too. “Emotional and psychological support go hand-in-hand with medical treatment options,” Dr. Sherry says.
For many, half of the battle was just getting the diagnosis, which at least assured them they weren’t imagining their symptoms. “Before I was diagnosed and understood that what I was experiencing was normal, I was so frustrated,” says Megan.
Megan continues, “Even though I do still get kind of frustrated and ask ‘why me’ a lot, it’s made a world of difference just to know that there are others going through what I am and that I’m not some kind of freak of nature. [My] emotional health has improved a lot knowing my diagnoses and that there’s a path to overcome at least some of what I’m dealing with.”
After your diagnosis, finding people to talk about the stress of vaginismus with can help alleviate the emotional toll too, whether that be a therapist or loved one.
What about your period?
A lot of women talk about tampons like it’s NBD. That time of the month is annoying and painful enough, but many women with vaginismus deal with the added stress of figuring out how to keep everything nice and tidy when tampons aren’t a good option.
Lara uses Thinx panties as an alternative option. “I am obsessed. When I can’t just rely on Thinx panties on heavy flow days, I’ll use organic cotton pads and the occasional tampon,” she says. “It took me a long time, lots of physical therapy and lots of dilator use to be able to use a tampon, so it still feels like a big deal to use one.”
Of course, you could always just use a pad. Despite the stigma of people calling them “diapers,” that’s literally so dumb, so you do you. You can also experiment with birth control methods that limit or eliminate periods.
“I am on the birth control shot which stops your period altogether,” Megan says. “I would definitely recommend this to anyone struggling with vaginismus since it removes the need for tampons altogether.”
Now, there are so many options for period management, so use whatever makes you feel best.
What about sex?
The real world isn’t Gossip Girl. Sex isn’t easy and breezy for a lot of people. Dating and sex lives can already be complicated, and discussing vag problems with potential partners doesn’t really help set the mood for a Blair and Chuck limo scene.
“I’m kind of afraid of relationships, even though I’d love to be in one. It feels like college is just focused on hookup culture and I don’t know if I can actually ‘hook up’,” Marissa* says. “It often feels like guys are just interested in penetrative sex and that they’d reject me and get mad if they found out mid-hook up that I couldn’t do that…it’s not like I can walk up to a guy and be like ‘Hey, my vagina hurts when things go in it!’”
But sex can be possible and, yes, just maybe enjoyable.
Finding an understanding partner or SO is huge. If they’re always making you feel nervous then your vagina will just feel more clenched and make things worse. So, you should be around someone you can relax with.
“I’ve been lucky enough to be with a very patient and supportive partner who has really helped me overcome a lot of my symptoms, but the first time I had sex it was painful, and honestly, nearly impossible,” Megan says. “Even now, I’m not someone who can have sex super frequently, and there are a few positions that will probably always be off-limits for me…. My ability to enjoy sex and not be in pain really varies a lot day by day.”
Hopefully, everyone can find someone who loves them, vaginismus and all, but life is not always a fairytale.
“In college, I tried to date a lot, but I really didn’t know what was going on with my body,” Lara says. “The few times that I actually did try to be sexual, it ended in a lot of pain, and a lot of asshole guys who weren’t understanding.”
Mackenzie says physical therapy has helped a lot and her own little routine of wine, ibuprofen and sometimes a bath helps ease the pain too. However, before she got to that point, vaginismus affected her and her ex’s intimacy.
“My ex, who I was with at the time I got diagnosed, didn’t understand the issue,” says Mackenzie. “Prior to receiving treatment, the pain led to a total lack of desire to partake in anything. After being diagnosed though, I was told I couldn’t have sex until the pain was gone. This caused major strain in our relationship, and while I wouldn’t say it was the primary reason for our break-up, the pressure definitely contributed.”
Having to discuss a personal issue with someone you may or may not know super well can be daunting.
“You’re in a pretty vulnerable state when you’re about to have sex with someone for the first time, and the fear of rejection, because you aren’t normal, is definitely still present,” Mackenzie admits.
You might feel like you’re not “normal,” but there are plenty of vaginal conditions that women suffer from out there. This condition doesn’t make you any less than a woman who doesn’t suffer from these types of conditions.
That being said, communicating with your partner about vaginismus might not seem like the sexiest thing, but you and them will be better off for it.
“I can have sex now, and while moments/positions can be somewhat painful, the pain is much more bearable,” Mackenzie says. “It’s not always like that though, I’d say for the most part I can enjoy sex. I’ve yet to be able to experience an orgasm, and while that does make me a bit anxious sometimes, I don’t think it’s impossible. I’m already so much better than I was before, and I still think I can keep improving.”
With time and treatment, things can get better. “If I could go back in time, I would just tell myself that I don’t need to have sex to be loved or for someone to hang out with me. It’s difficult,” Lara says.
Laura adds, “And in college, it seems like literally, every single person around you is having sex, and when you can’t, it’s like, ‘what the fuck?’ But any person who gets upset about something causing you pain is just not someone you should be around, period.”
That kind of self-empowerment might take some time, but realizing your worthy of being treated right will only make your future relationships that much better.
“You’re not alone, it’s not a deal-breaker, and there are many ways to be intimate if you so wish,” Lara says.
And so…
Life goes on. Having vaginismus isn’t something to be swept under the rug. It should be addressed and treated, for your sake. But, you cannot be reduced to a medical term. You’re so much more than that.
“It sounds cliché, but everyone, I mean everyone, has some sort of baggage. Having baggage in the form of vagina problems doesn’t make you any less worthy or lovable than anyone else. It sucks — and I never want to discount that — but it does not define you,” Lara says. “It’s a part of your life, maybe a chapter, but not the whole damn book.”
*Name has been changed