Welcome to Doing It, a column where sex educator Varuna Srinivasan explores the deep connections between sex and emotions. This month, they speak with experts and people living with vaginismus about the realities of living with this under-researched condition.
The vagina is a remarkable organ. It connects the uterus to the outside of the body. In a near constant state of change, the vagina is capable of pushing out a baby, regulating its own pH, and getting rid of any blood or discharge that the body doesn’t need.
When aroused, it has the power to self lubricate and elongate, making the process of penetration pleasurable. But sometimes, despite these accommodations, women can experience pain or discomfort during sex. According to the American College of Obstetricians and Gynecologists (ACOG), nearly 3 out of 4 women experience pain during sex at some point in their lives. These one-off instances can be attributed to many different things, like vaginal dryness or a particular position. As long as these moments of pain are rare, they’re typically nothing to worry about.
However, consistently experiencing pain, before, during or after sex is a situation that warrants more attention. According to the ACOG, sexual pain includes two conditions: dyspareunia, which is essentially an umbrella term for painful sex, and vaginismus, which is the involuntary spasmodic tensing of the muscles of the vagina. Vaginismus can make any type of penetration, including the insertion of tampons or digital exams at a doctor’s office, painful. The severity of the condition can vary, making penetration anywhere from somewhat difficult (perhaps inserting a tampon is fine, but having penetrative sex causes pain) to almost impossible under any circumstance.
The ACOG estimates that vaginismus affects 1 to 6% of women. Most studies and medical articles state that the cause of vaginismus is “unknown,” which likely refers more to the exact biological mechanism causing the involuntary spasms. However, experts are in agreement that these spasms are likely a side effect that can be caused by a variety of physical, psychological, or sexual factors.
The symptoms of vaginismus vary, but can include burning, tension, or pain during penetration; avoidance or fear of sex; and tightening of the vagina. The symptoms themselves can, in a way, make the condition worse. “These symptoms often lead to increased apprehension or fear of penetration in anticipation of pain,” says Elizabeth Perri, psyD, a licensed clinical psychologist and certified sex therapist.