There exists a vast amount of misinformation surrounding vaginismus, particularly around its causes and how to successfully resolve it.
Some sexual/medical professionals lack an adequate understanding of vaginismus and that incorrect information is conveyed to women – having a negative impact upon their recovery.
Clients have relayed conversations they have had with doctors, psychosexual therapists and counsellors that highlight how much ignorance there is around vaginismus; I have worked with a number of clients who have undergone operations on their hymen, only to discover that the vaginismus persists after the surgery. One such client was a doctor herself.
Below is my video dispelling a couple of these myths...
Vaginismus is a physical issue and you need physical therapy to overcome it.
It can feel quite bewildering for women to understand what is actually going on downstairs when vaginismus is occurring.
So many of the women that I have treated for vaginismus initially attributed the symptom to a physical abnormality, believing that there must be something wrong with their vagina. Many women describe a physical blockage as like hitting a wall. They believe their vagina was simply too narrow, too shallow or their hymen was preventing penetration.
Of course, it makes sense to think of vaginismus as a physical problem, after all, it manifests itself in very physically obvious ways so it can appear that there is a block preventing you from having sex or any form of penetration. I have also heard vaginismus being compared to having a physical injury, and the sufferer should be treated in the same manner as a person with a broken arm.
Your vagina is not broken or injured! But you are really good at tensing...
You are squeezing your muscles in response to the fear and trepidation you are creating in your mind.
Our mind is an remarkably powerful device and the thoughts we create can have an incredible impact upon our body. Simply with the power of our imagination we have the ability to create a whole host of physical sensations: we can make our heart race by thinking of a frightening situation; we can create a headache by feeling stressed. We can make ourselves cry by thinking sad thoughts.
Take a person with a fear of flying. When they are on a plane they may feel nervous at take off or landing, or when the plane encounters turbulence. Their fear leads to grip the arm rests of the chair. Of course their arm muscles are tensing….but only in response to their catastrophic thinking that the plane is going to plummet out of the sky. The minute they relax and stop thinking these terrifying thoughts, their body relaxes.
By treating vaginsmus as a purely physical problem, is to divert attention away from the TRUE source of the tension….which is the mindset behind the physical response.
Vaginismus is caused by your muscles 'spasming'
Vaginal spasm has been considered the defining diagnostic characteristic of vaginismus for approximately 150 years. The available empirical research, however, does not support this definition (Binik et al, 2010). The very concept of a spasm unnecessarily medicalises the condition and implies a complex physical response that may continue over a long period of time. Encouragingly, the spasm-based definition of vaginismus was dropped from the latest edition of DSM-5 (the medical professional’s ‘bible’), mainly because there exists NO evidence that the vaginal muscles are actually going into spasm during vaginismus. There is much research to support this: Lahaie et al’s 2004 comprehensive review of the literature on the diagnosis, cause and treatment of vaginismus states that “vaginal muscle spasm is not a valid or reliable diagnostic criterion for vaginismus...(it) has never been empirically validated.
The term spasm itself is also controversial as there is no agreement on whether spasm refers to an involuntary muscle cramp, a defensive mechanism or a hypertonicity (a state of high tension) of the pelvic floor muscles.” The American College of Obstetricians and Gynaecologists provide no guidelines regarding the manner in which vaginal spasms in vaginismus should be identified and measured. Reissing et al (2004) states that “Investigations into the nature of the proposed spasm have shown that it is not reliably elicited during internal examination”.
This inaccuracy in its definition isn’t just a minor technical detail but has major implications for understanding vaginismus and how to effectively treat it.
The reality is that the physical processes which cause vaginismus are really quite straightforward: you are simply TENSING your muscles, in the same way that a nervous airplane passenger may tense the muscles in their hand as they grip the arm rest of their airplane seat.
Can I ask you to tense your jaw muscles right now for a few seconds…and release. This is exactly the same tensing process that occurs to your PC muscles when attempting penetration. And while you’re there, please do the same with your PC muscles. To locate them, they are the ones that you would tense in order to stop the flow of urine when you’re having a wee. Squeeze and relax them now. In the absence of any unhelpful thoughts and anxieties you can have complete control over this action. Your ultimate aim is for you to have that degree of control during penetration (as far-fetched as that idea may seem right now!). By understanding and mastering the thinking that drives your body’s responses you can learn to achieve that level of control.
It has also been suggested by vaginismus ‘experts’ that the condition should be treated in the same way as a physical injury, such as a broken arm. Let me reassure you that your vagina is NOT broken. It’s not even poorly! There is nothing that needs to heal, so overcoming the condition need not be a long, drawn-out period. Here is an analogy to explain what I mean: I am currently typing this sentence using Microsoft Word (the software) on my Apple Mac computer (the hardware). Occasionally, I have encountered a problem where the software has frozen and I have had to force quit the programme. The cause of the problem was not with the hardware - my computer was doing exactly what it was designed to do - but it was the software that wasn’t performing correctly. Similarly, you do not have a fault with your hardware (your vagina), but the software that controls it (your thinking) has become temporarily corrupted.
The Thrive Programme simplifies and clearly explains what is happening to your body to create vaginismus...and how to effectively overcome it.
Challenging Unhelpful Vaginismus Myths by Cara Ostryn Bsc