Research shows that naming feelings helps manage them.
In this episode, three BANG! listeners name the things they've struggled with and talk about the steps they've taken to deal with them. Father-daughter sex advice duo Nic and Lena Beets also offer some practical advice.
Featured below is Anna’s* story, about her experience with a condition called vaginismus. Listen to the full podcast episode to hear John* talking about erectile dysfunction, and Chessie and Amy on menstruation and “period sex”.
Anna was undergoing a routine pap smear when she realised something was wrong.
“I was in a lot of pain and swearing a lot at the doctor,” she says. The doctor, seeing nothing wrong with Anna’s vagina, continued her examination as normal despite her protestations.
After the pap smear alerted her GP to a polyp that required surgery, Anna had a follow up gynaecological exam that was equally painful. This time her doctor knew what was going on, and after a short conversation, informed Anna that she had something called vaginismus.
“She said to me ‘If you ever think about having children use an epidural’… And that was pretty much the end of the conversation,” says Anna.
Like any person who’d just had a medical label slapped on them with little explanation, Anna went straight home and started researching.
Described as an “involuntary contraction of muscles around the opening of the vagina in women with no abnormalities in the genital organs,” vaginismus can make sexual intercourse or any activity involving vaginal penetration (including inserting a tampon) painful or impossible. People who experience it say that it feels as if a wall has appeared in the vagina. When penetration is forced (be it by a GP or when a vaginismus sufferer is trying to “push through’ with a partner), it can be incredibly painful.
Primary vaginismus is when a person has never been able to enjoy pain-free vaginal penetration of any kind, and secondary vaginismus is when, like Anna, a person’s sex life has been just fine and then this appears as if out of nowhere.
Vaginismus is poorly studied but is believed to occur in 1-6% of women. Sometimes there is no obvious cause, but it can be related to a belief that sex is wrong or shameful, and traumatic early childhood experiences that aren’t necessarily sexual in nature.
Regular BANG! guest, psychologist and sex therapist Nic Beets says one of the most common causes of vaginismus is a person “having sex when they’re not ready, not aroused, not lubricated.”
“[The sex is] painful, and then they start to build up a negative anticipation towards sex, it becomes increasingly painful because they’re finding it harder and harder to get aroused, and you get the whole cycle going,” he says.
Vaginismus can also occur following sexual assault and abuse, which is what happened to Anna.
Being diagnosed with vaginismus has helped Anna understand what’s happening to her body, but it hasn’t necessarily helped with getting treatment.
“I don’t know if I would feel comfortable talking to my GP about it, especially after my last experience with the pap smear,” she says.
“Where are the people who are letting me know about the treatment or guiding me through? What about the other people with vaginas who are experiencing this same problem and don’t know about it?”
Treatment for vaginismus involves a pelvic floor physiotherapist who trains the patient to be aware of and in control of the muscles in the vagina. Therapy can also be helpful, where trauma is a factor.
But the first step is a checkup with a sexual health specialist to make sure there isn’t another reason for the pain.
“Infections, even thrush, those kinds of things can be the source of the pain so that usually needs to get checked out, and unfortunately what can happen is that some doctors will get very focused on trying to find a medical cause and treat it, so it’s really important that you go to doctor that’s focused on your general sexual wellbeing,” says Nic Beets.
HELP WITH VAGINISMUS
If you would like to talk to someone about treatment for vaginismus, or explore whether this diagnosis is right for you, a sexual health clinic is a good place to start.
Here is a list of all New Zealand sexual health clinics: https://www.nzshs.org/clinics
If you know other sexual health practitioners and pelvic floor physics with experience in treating vaginismus, email firstname.lastname@example.org and let us know.
* Names have been changed