The silent sexual problem many women ignore

In a world where we are focused on empowering women, it’s surprising to find many are suffering in silence with a common sexual problem.

An observational study was conducted in a sexual health clinic in the US and recorded nearly 50 per cent of women suffered from a disorder now known as vaginismus – the inability to comfortably have anything penetrate the vagina.

Although it’s not a new thing, there hasn’t been a lot of specific research conducted within Australia. The closest data would be a study of 20,000 people, which found 20 per cent of women had experienced pain during sex for at least one month.

We take a look at this little-known disorder with Sydney-based GP and female health specialist Dr Jill Forer.

What is it?

For the last 175 years, vaginismus was considered to be a vaginal spasm, but Dr Forer explains it’s actually a “phobia related to the fear of penetration or the fear of intended penetration”.

This phobia makes sexual intercourse, or even inserting a tampon, impossible without a high level of discomfort.

Now, it’s listed as a Genito-Pelvic Pain/Penetration Disorder (GPPPD) and Dr Forer reveals there are five recognised types:

  • Primary: Lifelong pain with any type of attempted, or any idea of, vaginal penetration.
  • Secondary: An inability to experience penetration occurs after a period of being able to have some sort of penetration – this is the most common type.
  • Situational: Inability to withstand certain types of penetration.
  • Spasmodic: Vaginal spasm.
  • Complete: Inability to tolerate any penetration at all.

Causes

Originally, it was thought that those who suffered were exposed to painful sex or assault, but that has now been disproven.

In fact, Dr Forer says in most cases there’s no past trauma involved. “The cause of vaginismus really ranges because it isn’t a physical ailment as such,” she explains.

Diagnosis

According to Dr Forer, this disorder often goes untreated due to the embarrassment associated with talking about something so private.

“Women often feel a lot of self and social judgement with sensitive issues like this, so they just don't talk about it or they mask it with something else like having a low libido,” she says.

Due to the lack of physical evidence, it’s a tough one to diagnose so doctors have to rely on observation and questioning.

Living with vaginismus can cause a whole host of problems from relationship issues to social and emotional issues, Dr Forer explains.

Treatment

The good news is, vaginimus is treatable. Dr Forer reveals her favoured approach, which combines physical and emotional therapy.

“We work with a sex therapist and a physiotherapist, who specialises in pelvic floor physio,” she says. “They are trained to examine and get ‘hands on’ with the patient and are skilled in the use of dilators – not to make the vagina bigger, it’s still normal size, but to get the patient used to it without triggering a fear response.”

While the length of therapy is case-by-case, Dr Forer explains that generally after about three months of 2-3 sessions per week have a great result.

Another method is to use Botox to relax the perineum muscles in the pelvic sling, but Dr Forer warns this is not a cure as it simply stops the muscles from being able to tighten. .

“People are embarrassed about talking about emotional issues, but we need to get people talking about it because it’s treatable and you don’t have to put up with that pain.”

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