Thrive Coach and co-author of the Cure your Vaginismus and Thrive book, Cara Ostryn, discusses five common misconceptions about sexual pain and anxiety:

“Vaginismus is a sexual problem affecting women. It causes penetration to be painful or impossible due to the tensing of the vaginal muscles – the sensation is often described as hitting a ‘brick wall’. Sufferers may also experience anxiety and difficulty inserting tampons or undergoing gynaecological examinations. 

It is extremely frustrating to be unable to physically engage in pleasurable sex and sufferers often feel abnormal, ashamed and deeply embarrassed about the condition. This can lead to avoidance of penetration, a feeling of alienation from ones own body and relationships can break under the strain of a non-sexual partnership. 

There exists a great deal of myths and misinformation surrounding vaginismus, especially around its causes and what is required to successfully treat it. To help rectify this, below are FIVE things you didn’t know about vaginismus:

1. It is a widely misunderstood and misdiagnosed condition

Most of the general public have never heard of vaginismus. Because of a lack of information, sufferers may assume that it is not a recognised condition and so do not investigate it further. Indeed, many women only discover their symptom has a name after their own internet research. This is vastly different to men’s sexual problems, such as premature ejaculation, which is a well-known symptom and information about it can be easily found. Spam emails are commonly sent from companies offering pills and gadgets to enable men to achieve firmer, longer-lasting erections. I’m yet to receive a promotion offering a solution for a more relaxed, wider vagina!

Vaginismus may go undiagnosed by doctors and sex therapists because of inadequate training and understanding of the condition. There exists no official gynaecological system for diagnosing the condition. I frequently hear my clients tell me about unhelpful comments from their doctors such as advising them to ‘just relax’ about sex or recommending that she have a glass of wine! This is the equivalent of telling a depressed person to “cheer up, it may never happen!” 

2. Vaginismus is caused by psychological and emotional factors

…although it manifests itself physically. Similar to blushing when we feel embarrassed – the physical reaction is initially caused by our thinking/emotions. Many women attribute their vaginismus to a physical abnormality, believing that there must be something wrong with their vagina. They may believe their vagina is too narrow, too shallow or their hymen is preventing penetration. 

The reality is that vaginas are stretchy and elastic – when the minds that control them are relaxed! Our minds are remarkably powerful and the thoughts we create can have an incredible impact upon our body. Simply with the power of our imagination we have the ability to create a whole host of physical sensations: we can make our heart race by thinking of a frightening situation; we can create a headache by feeling stressed. 
By the same token, simply the dread and fear of penetration can have a massive impact upon how your body will respond to that very thing.

The most common interventions for vaginismus are those that focus almost solely on correcting its physical manifestations. I have worked with many women who had spent months or even years battling with dilators/vaginal trainers or physical relaxation exercises to overcome their vaginismus. Some have used botox to try and relax the muscles. Others have had unnecessary surgery on their vaginas . . . and still the vaginismus remains.

It has also been suggested by vaginismus ‘experts’ that the condition should be treated in the same way as a physical injury, such as a broken arm. Let me reassure you that your vagina is NOT broken. It’s not even poorly! There is nothing physical that needs to heal.Without having the necessary psychological understanding behind the condition, the women will often continue to respond in the same anxious, physically tense way to penetration. Because of this focus on the physical aspects of the symptom, the true psychological and emotional intricacies and components are overlooked or misunderstood.

3. It is NOT caused by a spasm in the vaginal muscles.

Vaginal spasm has been considered the defining diagnostic characteristic of vaginismus for approximately 150 years. However, there exists NO evidence that the vaginal muscles are going into spasm during vaginismus. The very concept of a spasm unnecessarily medicalises the condition and implies a complex physical response that may continue for an extended period of time. Encouragingly, the spasm-based definition of vaginismus was dropped from the latest edition of DSM-5 (the medical professional’s ‘bible’). This inaccuracy in its definition isn’t just a minor technical detail but has major implications for understanding vaginismus and how to effectively treat it.

The reality is that the physical processes which cause vaginismus are really quite straightforward: The muscles are simply tensing, in the same way that a nervous airplane passenger may tense the muscles in their hand as they grip the arm rest of their aeroplane seat.

4. There are similarities between vaginismus and other physical difficulties

To most vaginismus sufferers, the condition often seems like a hugely complicated and unique problem. However, it actually shares much in common with other physical symptoms and difficulties that people can encounter. A normal vagina is, by default, physically capable of penetration – it is only a set of unhelpful beliefs and thinking styles that causes the vaginal muscles to tense, thereby sabotaging successful penetration. There exist many other examples of where unhelpful thinking interferes with normal, natural physical responses, including sleeping, using public toilets and even speech. These are everyday things that our bodies are more than capable of doing naturally. However, a person’s anxious thoughts can interfere with, or completely prevent these natural processes, resulting in insomnia, shy bladder and stuttering.

5. Vaginismus is not directly caused by past experiences

Most literature on vaginismus suggests that it may be caused by such factors as sexual abuse or negative sexual experiences, strict parenting, religious upbringing, hearing tales from childhood about how painful sex will be, how much you’ll bleed…and so on. To counter this, nearly every piece of research into vaginismus demonstrates that there is no correlation between sexual abuse and vaginismus. Indeed, from my own clinical experience, the vast majority of my clients have never been sexual abused or have suffered sexual trauma. Likewise, most women who have had strict parenting or religious moral teaching don’t go on to develop vaginismus.
There is not a direct cause and effect relationship between past events and resulting symptoms. To explain this further, very few people who’ve been in a car crash go on to develop a phobia of driving. The crucial mediating factor is how we respond to events.

Symptoms, including vaginismus, develop not because of events, but how we react to them and the beliefs and thoughts we continue to hold about them. The great news is that whilst we are unable to change our past, we can change our beliefs and thinking today.

The ‘Cure your Vaginismus and Thrive Programme®’ is a complete psychological, emotional and physical solution to permanently resolving the condition. You will learn to understand and control the processes by which your mind and body interact. The very best way to treat vaginismus is by helping people to REALLY understand the condition in order to take back control over how one’s body responds to penetration.

Attention is also given to the dynamics within sexual relationships (current or potential) that may also be a contributory factor. In just a few weeks, you can feel powerful and back in control of how your body responds, making enjoyable penetration truly achievable.”

Click here for a free consultation to discuss learning how to overcome vaginismus and thrive. 

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