In this week's Sex IDK column, Emma McGowan, certified sex educator and writer, answers your questions about whether or not vaginismus can be cured.
Q: Will I ever recover from vaginismus?
Oh, Reader. I’m so sorry that this is even a question you have to ask. Vaginismus — an umbrella term for the involuntary contraction of the pelvic floor when something tries to enter the vagina — is under-diagnosed, misunderstood — and can be terrible to live with. People with vaginismus experience pain ranging from slight discomfort to stabbing sensations in their vulva and/or vagina when anything from a finger to a tampon to a sex toy to a penis tries to enter. It’s a constant and sometimes debilitating affliction, but vaginismus can be cured.
Unfortunately, many standard OB/GYNs aren’t well-versed in the symptoms and treatment of vaginismus. According to Dr. Sonia Bahlani, OB/GYN, a pelvic health specialists, people experiencing this type of vaginal pain are more likely to be told to drink a glass of wine and chill out before sex than to get proper treatment. As a result, thousands of people are suffering in silence.
“People think that it’s painful, and that’s just what they have to live with,” Dr. Bahlani tells Bustle. “And that’s just not true. You can absolutely recover from ‘vaginismus.’”
Because vaginismus can have various causes, Dr. Bahlani says that she doesn’t even use it as a term anymore. Instead, she prefers to work with clients to find the exact cause of their muscle contractions. For example, in some people, vaginismus is caused by very sensitive nerve endings in the entrance of the vagina, or “vestibule.” If a client was experiencing that kind of pain, Dr. Bahlani would likely come back with a diagnosis of vulvodynia and recommend topical medications to soothe the area, internal pelvic therapy, and a few other treatments, depending on the individual.
“It’s like they’re hitting a rock because those muscles are contracting,” Dr. Bahlani says. “So then they’re cycling between vulvar pain and muscle contractions. It’s a chicken or egg problem.”
Another possibility is hypertonic pelvic floor muscle dysfunction, which is when the pelvic floor muscles tighten up and produce lactic acid, which causes spasms. Dr. Bahlani recommends pelvic floor therapy, muscle relaxant suppositories, and acupuncture in the pelvic floor for these patients. And, sometimes, she recommends therapy to clear away trauma responses.
Dr. Bahlani says that those are just two causes of vaginismus — and that the experience can be totally different from person to person. For example, some people may be able to insert a tampon, but then it feels like they’re pushing it out all day. On the other end of the spectrum, people’s muscles spasm violently if anything comes near the vaginal opening or vagina. But, no matter where you are on the spectrum, vaginismus can be cured.
“There are solutions out there — and don’t let anybody tell you differently,” Dr. Bahlani says. “This is not in your head; you’re not broken. There’s nothing wrong with you.”
Dr. Sonia Bahlani, OB/GYN and pelvic health and pain specialist, author of The Holistic Guide to Navigating Pelvic Pain