The Business of Vaginismus

By Dr. Bat Sheva Marcus

Vaginismus is a condition where a woman can’t get a penis into her vagina.

It can be mild, so mild that often-time she can get a penis in the vagina for very short periods but it’s unpleasant and painful. Or it can be severe, so severe that she can’t touch herself near her vagina, can’t have a gynecological exam, and can’t insert a tampon.

It is one of the most devastating conditions we see in patients. Not because the absence of intercourse does, by definition, mean that you can’t have a satisfying sex life. (As I always tell patients there are as many ways to have sex as there are body parts.) But women with vaginismus start to think that there is something crazy and abnormal about them. They start to feel horrible about themselves. They start to avoid any sexual encounters with partners. If they’re married or living with someone most often their “non-intercourse” sexual encounters taper off. Every time they have sex they feel like they should “try again,” and it hurts or they fail. Some just feel so terrible about the situation they find it easier not to think about it, and not having sex at all is one way to do that. Some single women even go so far as to stop dating altogether. We had one patient who was married for 11 years and had never consummated the marriage when she came to see us.

Seeing vaginismus patients has become a large part of our practice. I used to think it was much rarer than I do now. My heart breaks for these patients. Part of the problem is psychological, they are uptight, scared, anxious, petrified. Much of the problem is physical. Their vaginas are tight and there is pain. What always strikes me is how much avoidance these women exhibit. They have every excuse in the book why they haven’t dealt with the problem, can’t deal with it now, and can’t do the appropriate exercises. The physical part of it is very treatable, if they don’t run away petrified. But mostly I think women with vaginismus feel “crazy” and as if people knew the “truth” about them that they would think they were aberrant.

A question I am oftentimes asked is whether a woman who has vaginismus must have been sexually abused. I understand why people might think that. In a neat, linear way that makes sense, but the truth is I have seen absolutely no correlation between sexual abuse and vaginismus. So if you are suffering please don’t jump to the conclusion that you must have sexual abuse in your history that you’ve repressed the memory.

In every case (and yes, we mean every case) of Vaginismus, you can be helped. We see women who have suffered with Vaginismus for years and it makes us so sad. Of all the pain conditions, Vaginismus is the most successfully treated in the shortest amount of time. There is hope, and you’re not alone.