Vaginismus plagues, to some extent, about 22% of wives.
And for 7%, it makes penetration impossible.
Vaginismus is a sexual dysfunction disorder where the muscles of the vaginal wall contract involuntarily (you’re not deliberately causing it!), making penetration very painful or impossible, and sometimes even making tampon use or pelvic floor examinations difficult. It’s a condition that is far more common in religiously conservative women than the general population, and our surveys for The Great Sex Rescue bore this out.
This month on the blog we’ve been looking at the pelvic floor: the importance of the pelvic floor, postpartum recovery, what causes vaginismus, what to expect from a pelvic floor physiotherapist.
And today I want to talk about how to recover from vaginismus, and 8 healing things you can do.
Dealing with the Emotions of Vaginismus:
1. Don’t Feel Guilty About Having Vaginismus
It isn’t your fault. You did not cause this.
Please hear me on this one! One of the most common feelings when you have vaginismus is intense guilt. We’re supposed to give our husbands this incredible sex life, and our bodies aren’t even able! So many of us have internalized the “obligation sex” message that we are obligated to give our husbands sex because of our husbands’ great need. As we explained in our book The Great Sex Rescue, believing this is one of the big contributing causes of vaginismus. But believing this also makes recovery so much more difficult because we add guilt to the mix.
When you have vaginismus, he’s disappointed, and we feel so desperate to have him not be disappointed, because we want to be good wives.
I’ve talked about this before on the blog, and one commenter wrote:
He deserves better than this from me.
And my heart just breaks, because I understand, since I was there, too–for the first few years of our marriage.
We hear all about how he needs sex, and how he waited for sex, and now you’re supposed to give it to him and you can’t.
But guilt will not cure vaginismus.
In fact, guilt can make it worse, because in our guilt we can push ourselves too hard too fast. Like pelvic floor physiotherapist Bethany Peterson said in our pelvic floor podcast last week, if her patients are willing, she often invites husbands in to insert a finger and see how spasmed the muscles are. The wife is not causing this; it’s something she does not have control over. And you should not feel guilty for something that you’re not deliberately doing.
Talk about what you’re feeling. Tell him what you need, while reassuring him that you want to get better, too:
I need you to understand that it’s not that I’m rejecting sex; I’m rejecting pain. I want more than anything else to be able to have sex, and I want to work towards that, but right now we may have to find other things to do because I don’t want my brain to associate pain with sex any more than it already does. I want to work towards healing, and I’m going to really need your support and your affirmation, because I just feel so lousy about this.
2. Remember: No One Has the “Right” to Great Sex
What makes vaginismus so hard to deal with is that we feel cheated, but at the same time we also feel like we’re cheating our husbands.
But great sex is not a “right” or an “entitlement“. It is a gift that God gives to us in marriage, but that doesn’t mean that everyone will receive it at the same time.
Some people are born partially paralyzed. Some people are born deaf. Some people are in car accidents and live with chronic pain. You don’t have the “right” to a pain-free life or to hearing or to sight or to mobility any more than you have the right to great sex.
You aren’t being cheated, and you aren’t cheating anyone. You’re just experiencing a real disappointment. But it is one that can usually be successfully treated!
Overcoming Vaginismus Once and For All:
3. See a Pelvic Floor Physiotherapist
If your doctor tells you to just use a vibrator, get a different doctor. If your doctor dismisses your concerns, or says, “just give it time!”, get another doctor. If your doctor prescribes a recovery plan for vaginismus that scares you to death, get another opinion.
But above all, seek out a pelvic floor physiotherapist. Gynecologists may be able to diagnose vaginismus, but they’re not trained in treatment plans, and can often give the wrong advice. Pelvic floor physiotherapists are trained in how to help you, including giving you exercises to help you loosen and relax the muscles and achieve more control over them. Even if it’s pricey, it’s worth the investment if you can find the cash to deal with this. It often doesn’t take too many treatments, either.
4. Try Some Vaginal Dilators
Most treatment programs for vaginismus will include learning how to relax the muscles so that sex becomes possible–and comfortable. The easiest way to do this is to use vaginal dilators. I know that sounds scary, and they look kinda scary, but you can do it by yourself, at your own pace. You can use some lubricant with them, too! Most pelvic floor physiotherapists will recommend certain ones, and will tell you how to use them. Good dilators come in different sizes and are smooth and made of silicone or other medical grade materials to make insertion easy and cleaning easy, like this kit:
5. Learn to Relax and Isolate the Pelvic Floor Muscles
Your pelvic floor physiotherapist will help you find exercises to do, but learning to isolate the pelvic floor muscles and then relax them is so key. Bethany Peterson recommends this guided relaxation video from FemFusion for isolating the pelvic floor muscles.
FemFusion has other videos to help on their channel. As always, check with your physiotherapist first to make sure they’re the right exercises for you.
Sometimes even thinking about those muscles can cause us to panic, especially if one of the causes of vaginismus is shame about our bodies. But take some deep breaths, try to relax, and try some of these exercises. They can even be fun!
6. Look to All Possible Causes
And look at all possible causes of vaginismus. For some of us there’s a physical cause: the pelvic floor muscles which cause vaginismus are also affected by the bowel and by other parts of the body. Talking to a physiotherapist may help you find other causes. For some of us it’s trauma during childbirth. You may have been able to have sex fine beforehand, but after birth and some tearing you never recovered.
And then for many of us it’s teaching we had on sex when we were younger that made us feel like sex was something dirty, or teaching that we’re obligated to give him sex. For some of us it’s abuse. Talking to a counselor can really help, and may be all that’s needed to fix the problem.Also, so many women who have suffered from vaginismus have told us that The Great Sex Rescue has been so healing for them!
The Great Sex Rescue
Changing the conversation about sex & marriage in the evangelical church.
What if you’re NOT the problem with your sex life?
What if the things that you’ve been taught have messed things up–and what if there’s a way to escape these messages?
Welcome to the Great Sex Rescue.
I believe that in my case, vaginismus was multi-faceted. I had sucked my stomach in all the time, habitually, for 12 years by the time I married. Learning to un-suck was HARD! But that whole area of my body had never been relaxed. I also had some pretty nasty messages about sex that I had to dispel. So figuring out your own causes can be empowering, because it helps you know that you can get over this when you know there’s a reason for it.
Dealing with Sex While Vaginismus Is Still Being Treated:
7. Be Very Patient with Yourself–and with Your Husband
Forcing yourself to do something which is excrutiating will likely prolong the condition, because you further cement the association of pain with intercourse in your brain.
You also set up a really difficult emotional dynamic for your husband, where he can feel so guilty for wanting sex. Sometimes women can be the ones to push sex, even if it hurts, because we don’t want to feel like failures. But this is the wrong thing to do!
What often happens years later, after the pain goes away, is that both people have difficulty getting past the emotional dynamics they’ve created. He still feels guilty for wanting sex, and she resents the fact that he would do something that hurt her–even if she asked him to. You can avoid a lot of this by talking openly, working towards a cure, and having fun doing other things in the meantime.
8. Don’t Take Shortcuts to Arousal
One of the most common problems that couples get sucked into when vaginismus hits is fantasy and pornography. We women can be desperate to feel aroused, since sex doesn’t do it, and desperate to prove that we do have a sex drive, that we turn to porn or erotica. One of my friends who had vaginismus had a doctor tell her to a buy a vibrator. So she used it and enjoyed it, but it didn’t help at all with intercourse. And then she found her desire for her husband went away even more!
I’ve talked before on the blog about the common issue with dissociation during sex. When sex is painful, we often try to “dissociate” from our bodies and run anywhere but in our minds. That “anywhere but” can often be to fantasy, including with porn and erotica images. It allows you to feel sexually aroused and engaged even if your body isn’t actually enjoying things. Then, when vaginismus is cured, it’s hard to stop dissociating.
Other couples find that the husband turns to porn to deal with sexual frustration so that he doesn’t want to bother his wife. But porn is not harmless. The effects of porn are devastating on your libido and your sex life. And it won’t help vaginismus–it will only make you dissociate, so that when you’re having sex you’re thinking about something other than your husband. That hurts intimacy; it doesn’t enhance it.
9. Don’t Run Away from Sexual Intimacy
You may not be able to have intercourse comfortably, but that doesn’t mean that you can’t be sexual with each other! And, in fact, it’s even more important that you try, because you need the closeness that comes from being sexual, and you need the release from orgasm, and you need to know that your body can, actually, respond!
There are sexual options beyond intercourse, so don’t shy away from them! And as we found in The Great Sex Rescue surveys, most women who do reach orgasm reach it through routes OTHER than intercourse. So you’re not cheating or taking a shortcut. You can still enjoy each other!
I know vaginismus is a difficult thing to deal with.
Believe me, I do. But I’m also here to tell you that you don’t need to live with it forever; most women do indeed emerge on the other side. So take a deep breath, exhale all the guilt, and commit to working towards solutions!
Pelvic Floor Series
- Why the Pelvic Floor Matters
- PODCAST: What should you expect after childbirth?
- What Can You Expect from a Visit with a Pelvic Floor Physiotherapist?
- How to Recover from Childbirth
- Let’s Talk Postpartum Sex!
- The 4 Main Causes of Vaginismus
- The Pelvic Floor Podcast
- Overcoming Vaginismus
- Dealing with Secondary Vaginismus: A Newlywed’s Story
- Painful Sex: 6 Conditions Other Than Vaginismus that Can Make Sex Hurt
- How to Make a Pap Smear More Comfortable: 10 Tips to Help!
Do you have any advice or an article for a woman who is engaged and strongly suspects she has Vaginismus? Lots of fear around sex, she’s been suppressing any sexuality for many years, and has some body shame too. Plus a traumatic incident with a male doctor swabbing her when she was 11.
Honestly, I would read The Great Sex REscue and The Body Keeps the Score, and then see a counselor before she’s married–along with a pelvic floor physiotherapist so she can be sure that she’s okay! Do the work early.
I second reading The Great Sex Rescue and also The Good Girl’s Guide to Great Sex. And all Sheila’s advice on here, particularly the stuff aimed at brides to be/newly weds!
Also, having a frank and open conversation with her fiance about her concerns, to make sure they are both on the same page about taking things slowly, focusing on intimacy rather than sex, waiting for arousal before trying intercourse.
If seeing a medical professional, I’d make sure she finds one who is respectful and understanding of those who save sex for marriage. Some of my biggest hangups around sex came from being shamed by doctors for my lack of sexual experience – being told you’re ‘abnormal’ for being a virgin really doesn’t help, neither does being told that you wouldn’t have any issues if you slept around a bit, and those memories increased my apprehension leading up to our wedding night.
NB: If she can’t use a tampon, it doesn’t necessarily mean she’ll have a problem with intercourse. I’ve never been able to use one, and when I was prescribed a cream which came in a rigid plastic applicator I couldn’t use that either. We did lead up to intercourse very slowly, but it was never anything like as difficult as tampons & medical exams have been.
Such an important topic that affects so many women, yet it’s never talked about.
Vaginismus is a couple’s challenge, not just a woman’s problem. If the man and woman can overcome this together, there is nothing they won’t be able to face in life.
Yes, this!! If I had read this 20 years ago it would have transformed my life. I have had vestibulitis and vaginismus all of my life and I am 42. This article is wonderful in explaining the reasons and treatment but I would offer the following based on my personal experience – the guilt /shame/closing up can also be because of the woman’s desire and sensuality not anything to do with the man. For me raised Catholic and sexually active from a young age I felt ashamed of my personal powerful sexual desire and passion as a woman because I had never been taught about female sensuality and desire. I tried to squash it and was ashamed of how much I enjoyed sex.
Over decades of treatment including surgery (Vestibulectomy – horrific – please nobody do this!) Hormone treatment, counselling, deliverance prayer, mindfulness, pelvic floor physio therapy, etc – I can finally say that sex is about 80-95% pain free and the guilt and shame is about 95% gone!
I would recommend this to others which has helped me – after decades of trying to hide my sexual activity from God I now do the opposite. Just before sex or at the start I pray! I pray for my body to respond naturally to my husband and to enjoy making love. I thank God for sex! I declare to myself that sex is natural and good – God’s gift to our marriage and that is His plan and will that we have sex in our marriage. I bless my body and my vagina and I visualise it opening like a flower (a la Song of Songs) and I bless our marriage and our sex.
It has really really transformed our marriage! My husband had turned to porn for decades because he didn’t want to bother me.or hurt me and because he was so frustrated. That’s a whole other story !
Sheila thank you for writing about this I can honestly say that it can and will.be life changing for women. I am.more than happy to share more about my experiences if you think it will be helpful.
Blessings,
Beth x
this article is too late for me—married since the 1970’s years and always had the pain of a knife but with no internet and no money for doctors i finally gave it up decades ago….top it all off with the rule of patriarchy from our church and gothard, it is a wonder—no it isn’t–i did have a nervous breakdown/ cancer and other stress/guilt related issues all the while still working and holding a job since my husband was sick all the time… it is a wonder we are still together…oh yeah, that thing about god hating divorce—poor hubby had his issues, illness after illness after illness and to patriarchy had me belieiving it was all my fault, no wonder we had 2 tornadoes hit our house in 3 years!!!! i deserved all the punishment for being such a bad wife!!!
Oh, Ann, I’m so sorry. Are you in a better community now that’s healthy?
My daughter is almost 40, and had pain at first and probably no sex since. Their only child will be 18 in March. I’ve shared your Good Girls’ Guide, and she appreciates it. She needs a “Pelvic Floor Physiotherapist,” but lives 3 hrs from any possibility of finding one, and can’t afford the travel (both financially and health-wise).
Is there anything else you can recommend?
I listened to one of your emotions podcasts that you were going to have a vaginismus survey. Is that survey out yet and, if so, where can I take it? Vaginismus has had devastating effects on me and my marriage.
It isn’t out yet, no. But if you sign up for my emails then you’ll be notified when it is! And I’m so sorry for your burden of vaginismus. That was my story too.