Understanding and Supporting Your Partner with Vaginismus
When in a relationship or a marriage, vaginismus affects both individuals albeit in different ways. In this blog post, we’ll discuss the impact on the partner/husband and provide tips for how to navigate, help, and manage this condition. Dealing with vaginismus is difficult for the woman and man in a relationship.
Definition and Symptoms of Vaginismus
Watch our video, What is Vaginismus?
Vaginismus, also known as genito-pelvic pain/penetration disorder, is when there is an involuntary contraction of the pelvic floor muscles that surround the vagina whenever vaginal penetration is attempted. This contraction can make sexual intercourse, gynecological examinations, and even inserting a tampon difficult or impossible, leading to pain, distress, and a significant impact all aspects of life. The muscle tightening can be so strong in some cases that it is described as a “vaginal spasm”.
Symptoms of vaginismus include
- Pain Upon Penetration: the consistent or recurrent pain, often described as a “burning” or “tearing” sensation;
- Burning Sensation: A burning feeling at the vaginal opening during and after attempting penetration;
- Hitting the Wall sensation: the feeling of a barrier when attempting penetration;
- Other penetrations that are often affected: difficulty or inability to insert tampons, menstrual discs, or cups, undergo a gynecological exam, or use a vaginal applicator for medication;
- Feeling of Muscle Tightening: this guarding may start when just thinking about penetration, even before actually attempting it;
- Fear, Anxiety, Concerns About Vaginal Damage: this is because vaginismus is ALWAYS an anxiety-based condition, which catastrophizes and makes the woman ‘brace for impact;’
- Avoidance: The above-mentioned symptoms cause many women with vaginismus to forgo entering into relationships, avoid sexual intimacy, undergo gynecological examination, or any other activity that may remind them of this condition.
Causes of Vaginismus
Vaginismus is always a symptom of an underlying anxiety condition. With anxiety being an instantaneous, illogical reaction, the causes of vaginismus are characterized by a worrisome and panicky nature:
- Fear of Pain (that may or may not even present!);
- Fear of the Unknown: what will penetration feel like?
- Religious Taboos and Sexual Mandates;
- Misunderstandings About the Vagina: Since the vagina is an invisible body part, it can lead to misconceptions and fears;
- Past Negative Experiences: Previous discomforts, such as infections or rough partners, can lead to fear of future pain;
- Misconceptions about Sex;
- Inability to Refuse Unwanted Sex;
- Over-Protectiveness: Overprotective parenting can limit a person’s ability to deal with challenges related to intimacy;
- Sexual Abuse and Sexual Trauma: Contrary to common belief, sexual trauma is the least cause of vaginismus. When it is the underlying reason, it can lead to vaginismus as a protective response against further distress, though it’s not the sole cause. Some women with vaginismus have experienced trauma, but many have not, emphasizing the multifaceted origins of the condition.
Types of Vaginismus: Primary vs. Secondary
Primary vaginismus occurs when the woman has never been able to achieve vaginal penetration without pain, including sexual intercourse. This means she has always experienced pain from her first attempt at intercourse or even from trying to insert a tampon.
Secondary vaginismus occurs when a woman who previously had pain-free penetrations develops pain or difficulty after life events such as surgery, menopause, cancer treatment, emotional crisis, or infections.
How Can I Help My Partner Overcome Vaginismus?
Being a supportive partner is essential, not only for the relationship but also for the treatment process. Whenever we had patients whose partners/husbands were not at all supportive and attentive, it took quite a heavy toll on the women to stay positive about the relationship while also keeping a steady pace with the treatment which is always challenging.
Effective Communication with Your Wife or Girlfriend with Vaginismus
Vaginismus is a medical condition. Vaginismus is NOT about her love for the partner/husband. Vaginismus is not a condition the woman wants to have – she never asked for it! Therefore, vaginismus needs to be addressed for what it is, including how each party feels about it and how it affects them: angry, resentful, compromised, helpless, inadequate and many other such deep feelings. The more the couple is facing their feelings, the better the prognosis of vaginismus and the stability of the relationship.
Encouraging Intimacy Without Penetration
The sexual menu includes many options, with penetrative sexual intercourse being one of them. Even when the latter is not available due to the vaginismus, other sexual activities can be had, with full satisfaction and a deep intimate connection. Yes, this is a bit of a compromise, but it is about making the best and staying positive with what IS available. Watch our video, How to Have Sex: What’s on Your Sexual Menu.
Working with an Expert for Vaginismus Treatment
Although some women with (mild) vaginismus can self-treat, the majority will want to engage the services of a vaginismus specialist who will guide them through the process of overcoming the condition as well as provide emotional and communication support. While treatment is a challenging journey, progress is definitely possible, and the sense of relief that comes with a cure is extremely powerful. Do your research to find the most suitable expert and never hesitate to ask them questions, such as how many vaginismus cases they see per week/month/year, how many treatment sessions will be needed, their definition of success, their cure rate, whether they also offer online interventions, etc. Start at your locale but keep an open mind for traveling if the best option is far from home.
What Are the Treatment Options for Vaginismus?
Any treatment option for vaginismus should address the psychosomatic nature of the condition as well as owning all vaginal penetrations, ideally at the same time by expert clinicians. An in-person treatment is always the best way but since it is not always possible, virtual coaching is a viable option. Sadly, there are few such experts who simultaneously treat the ‘entirety’ of vaginismus. If you cannot locate such a specialist, you may opt to try with any combination of the following methods:
Understanding the Role of Pelvic Floor Therapy
A qualified physical therapist can guide those experiencing vaginismus in relaxing and managing their pelvic floor muscles, which can help reduce involuntary contractions.
Exploring Psychological Support for Vaginismus Patients
Working with a qualified therapist or counselor can help individuals address any underlying psychological or emotional factors contributing to vaginismus. This may involve cognitive-behavioral therapy, mindfulness techniques, or counseling
As an added anecdote, many believe or promote vaginal dilators as a treatment option for vaginismus, but this is far from an effective treatment.
How Does Vaginismus Affect Sexual Activity?
As was mentioned above, vaginismus can easily derail a woman’s sexual interest as well as affect her sexual intimacy if she has a partner. That is because of shame, feeling inadequate, feeling less than a normal woman, not understanding what vaginismus is, sexual or emotional pressure by a partner, pressure to perform/get pregnant, etc. At times, women will decline dating or entering into a meaningful relationship, or will choose a partner who is not really ‘available’ for sexual intimacy.
However, we’ll be remiss if not highlighting that many women do not allow the above to stop them from enjoying a wide variety of sexual activities as per their available Sexual Menu choices (see above and watch the video). Yet these women will still feel incomplete until they are able to overcome the condition.
What Should We Men Expect During the Journey to Overcome Vaginismus?
Although supporting and encouraging her during treatment is vital, the actual process is hers. She is the one to overcome her vagina anxiety and to reclaim proper vaginal function. So what should the male partner expect during this process?
- Follow the clinician’s advice and guidance;
- Show her that you care, express your support for her fears and worries about the condition, and reassure her of your unwavering commitment to be there all the way;
- Help with doing online searches for resources and solutions, inquire about insurance and treatment details, assist with transportation if necessary, and maintain an encouraging attitude;
- Do not force an opinion, respect her feelings yet keep encouraging her to move forward, do not ask for nor demand sexual intercourse until given the go-ahead by the treating clinician;
- Fend family pressure and questioning about ‘why are you not pregnant yet’ or ‘when will you give us a grandchild’ by firmly saying that you and your wife/partner will share the news when you are ready to do so, and ask for privacy until then.
Recognizing Progress and Setbacks
Vaginismus is a crystal clear condition: easily diagnosed by the inability or great difficulty with vaginal penetrations. Consequently, progress is easy to spot: can she do more today than prior? Is she now able to have some penetrations without distress? Is there a clear path of moving forward, a plan, regarding the treatment process? Is there a quantifiable measure of how long the treatment will take? Is the anxiety better managed/controlled? Setbacks should not happen when proper treatment is in motion.
