Unlocking Intimacy: Understanding vaginismus with Olawunmi Esan

Understanding Vaginismus

Vaginismus is a topic that has been touched with a ten-foot pole for many years. Thanks to films like “Sex Education,” I learned about the condition, what it entailed, and its treatment. In season two, episode eight of Sex Education, Lily Iglehart and Ola Nyman discuss Lily’s newly discovered condition.

Vaginismus is the involuntary tightening of the muscles in the pelvic floor of a woman, which prevents penetration from happening. It is described as extremely painful when attempting to penetrate the vaginal area. People suffering from this condition often find it hard to have intercourse, insert tampons, or even have gynaecological exams because of the pain and tightened muscles.

Despite Lily’s enthusiasm toward sex, she did have a little bit of anxiety when it came up, which triggered her pelvic floor to close whenever there was a possibility of penetration. Lily described her vagina as a “venus flytrap” that wouldn’t let her have the experiences she wanted. But through physical and talk therapy, she gradually found herself on a path to healing.

What do we know about vaginismus?

Tima Miroshnichenko via Pexels

In a conversation with  Olawunmi Esan, an intimacy therapist and coach with a decade of experience, she shared insights into her treatment of women with the condition, highlighting the prevalent lack of awareness and the stigma associated with it.

“I do think a lot of people are not aware of what the condition is. There’s a lot of shame around sex in the first place, so very few people speak up.”

In her experience, Olawunmi Esan has discovered that many things could predispose a person to develop the condition, but these two stand out during treatment and diagnosis:

  • Sexual trauma: If a person experiences sexual trauma, such as sexual abuse, especially during early years, they may develop vaginismus when encountering consensual penetration.
  • Anxiety: because of previous ideologies and orientations surrounding sex, many women grow to become scared of sex, and husbands and sexual partners have likened it to hitting a brick wall.

While discussing the diagnosis of vaginismus, Olawunmi Esan extensively explained the differences and similarities between dyspareunia and vaginismus.

“Dyspareunia is an umbrella term for any kind of painful sex. This means that when any sort of penetration is attempted, and pain is felt before, during, or after sex, that pain can be categorised as a form of dyspareunia. Vaginismus is a form of dyspareunia.”

She explained that somebody can experience various types of pain during sex. “Some feel like lacerations when penetration is attempted, some people feel pain in their lower belly, and some feel pain at the point of penetration. Vaginismus, on the other hand, does not allow penetration at all. The pain is described by patients as excruciating and unbearable to the point of refusing sex entirely.”

“Vaginismus is a reflex action for people with the condition. It’s like when you try to put your hand in your eye, your eyelid shuts immediately to protect your eye.”

According to The Journal of Sexual Medicine, one to seven percent of the world’s female population is affected by vaginismus. However, the stigma surrounding the topic of sexual health has caused a severe lack of awareness on the issue, which is significantly detrimental to the general well-being of women.

The Experience

Aidi Tanndy via Pexels

To understand the vaginismus experience, we chatted with Gia (22) and Mimi (23) about their experience with the condition. They explained that their experiences with vaginismus were rooted in religious beliefs and abuse from when they were much younger.

Everyone’s experience with vaginismus is relatively distinctive, and the causes of vaginismus are not limited to sexual trauma and religious beliefs. Other causes of this condition include childbirth, menopause, sexually transmitted infections, and prior surgery. This article will familiarise you with the vaginismus experience, the stigma, and how to get help.

Exploring your body and understanding your needs is a natural phenomenon. Mimi’s desire for intimacy led to her first encounter with vaginismus. Her first sexual experience was interrupted by her inability to fit a finger.

“Getting a finger into my vagina was torture. I didn’t know what it was, but I knew it was uncomfortable and asked him to stop. I thought I wasn’t turned on enough, or I didn’t like him enough, but that wasn’t the case.”

Because of the lack of information surrounding the topic, Mimi never found the precise problem until two years later while scrolling through TikTok. Having the same experience not only during sex but when anything needs to penetrate, Mimi and Gia understood that the situation was much more complicated than not just being turned on.

The stigma from partners

The need to explain repeatedly to people can be a bit overwhelming and may cause women not to want to be intimate at all. For Gia, she didn’t bother with sex because of the extreme pain she felt at her first attempt. Even though it eventually happened, it was still excruciating.

“My current partner is aware of the condition, and my first time was with him. Unlike my previous partners, he took me seriously, and it was much more bearable with him. He read about it and made sure he was careful with me,” she says.

However, the reverse was the case with other guys for Mimi, as even the discussion about it was ‘pure torture.’  She explains, “They’re either dismissing it or taking it up as a challenge. One even chopped it up to just having a tight pussy, and I was so mad I never spoke to him again. Some people even try to force their way in, even when it obviously wouldn’t work.”

The lack of understanding of vaginismus amongst the opposite sex has made Mimi not have many sexual partners to reduce the hassle of explanation to Nigerian men.

Purity culture in the medical system

Medical practitioners often reveal more personal opinions than medical ones despite the expectation to provide an unbiased perspective on issues. They frequently lecture women, asserting that being unmarried is the cause of their predicaments and telling them that their bodies would only “open up” once married. This is a colossal misconception because, more often than not, vaginismus is the leading cause of unconsummated marriages.

Getting help

For both Gia and Mimi, their best option was getting therapy. Seeing as many gynaecologists as you need will help you find one you can be comfortable with. You don’t have to remain with one doctor all through.

“Watching a short film by Shelby Hadden called Tightly Wound helped me see that getting help was possible, and I wasn’t alone with the condition, even though it was pretty isolating.”

Mimi mentioned that discussing your challenges will get you all the needed help. Talk about it to whoever cares to listen and see as many doctors as you need to. Having a support system means overcoming your challenges.

To get the hang of this condition, here are different things you can do, as recommended by Olawunmi Esan:

Psychosexual therapy

Because the condition is mainly psychological, the first treatment should be psychological, starting with psychosexual therapy. To address anxiety or sexual trauma effectively, one must carefully deconstruct many of the individual’s ideas and orientations.

“What we try to do is not further to traumatise the person and to use a systematic desensitisation approach to help the person gradually get to that place of being able to accept penetration.”

Physiotherapy

Find a physiotherapist who is trained in pelvic floor disorders. The physiotherapist will work with the sex therapist to ensure that both the mind and body are healing uniformly. The physiotherapist would teach various exercises you can practise frequently.

Additional notes from Olawunmi

You might not get the consistent guidance you need from a gynaecologist. However, you can schedule appointments and progress through stages with a physiotherapist. I often recommend a combination of sex therapy and physiotherapy instead of immediately resorting to seeing a doctor.

I have worked with individuals who consulted medical professionals before turning to sex therapy. Some of them had even received advice to undergo surgery. Now, I want to clarify that I greatly respect the medical profession. However, some professionals are not well-versed or knowledgeable about certain conditions. In my experience, I recommend a combination of sex therapy and physical therapy.

Additionally, individuals can gradually learn to dilate on their own. While this might seem challenging, it’s pretty achievable. Professional assistance in sex therapy, along with guided dilation, personalizes body adjustments and techniques for the benefit of the individual. Many clients have successfully integrated self-dilation into their therapeutic journey.

Vaginismus is a typical condition that can make women feel very uncomfortable and embarrassed. It’s crucial to remember that you’re not alone and that efficient treatments are available. Please visit an intimacy therapist or the recommended healthcare professional for a diagnosis and treatment if you have vaginosis symptoms.

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