Unrealistic fairy tales of love in rom-coms depict sex as being natural for all. Yet, for women living with vaginismus, it can be more complex than just a romantic thrill.
This is a painful condition in which vaginal muscles spasm and contract when responding to physical contact or pressure. Aaliyah Harris investigates the need for access to vaginismus awareness, education and support from public health services.
“At 16, I tried to use a tampon, but I couldn’t. At 17, when I started my first serious relationship and we tried penetrative sex, it wouldn’t work,” says Lisa Mackenzie, co-founder of the Vaginismus Network. The network aims to build a community, raise recognition, remove stigma attached to vaginismus and provide honest information about it.
A Tight Vagina Doesn’t Mean Good Sex
Women experiencing discomfort during sex isn’t new and the myth that a tight vagina means better sex needs to be addressed. Mackenzie says: “We were fed the line that ‘the first time will hurt and its normal’… it shouldn’t”.
According to NHS advice, pain during sex may be related to illness, infection, a physical or a psychological problem. BJOG: An International Journal of Obstetrics and Gynaecology conducted a survey involving 6669 British women aged 16-74. Results published in 2017 show that 7.5% of women in Britain reported finding sex painful, an equivalent to 1 in 13 women in the UK.
Vaginismus isn’t just ‘all in your head’
The NHS says vaginismus can be caused “by a fear that your vagina is too small, a bad sexual experience, an unpleasant medical examination, a belief that sex is shameful or wrong or a painful medical condition such as thrush”.
Amy Crowther is a trainee chef from Cheshire and a member of the Vaginismus Network who was diagnosed with vaginismus in 2018. She says, “Having a close relationship to anxiety, I was a bit nervous at school and at 23 I started to get panic attacks”.
Dasha, a management consultant who does not wish to disclose her full name, has a secondary type of vaginismus where she once enjoyed sex but later developed the condition. Dasha believes that incidents of sexual assault and a relationship with an ex-partner who would frequently arouse her and then deny sexual intercourse triggered her condition. She says: “I was able to have sex, but psychologically my body stopped wanting to get aroused”.
Discussing assault and trauma, Dasha says: “Some guy appeared out of nowhere and grabbed me. Then [another time] a few guys that I met in a bar were trying to force me to have sex with them”.
Mental health issues like anxiety and trauma can trigger the onset of vaginismus. However, current public sector provision for mental health is poorly inadequate. In fact, Health Education England says that although “one-in-four of us will experience mental health problems, mental health services remain the poor relation to physical health services”.
The Mental Health Data Hub shows statistics by an NHS (Westminster) clinical commissioning group (CCG). This graph shows an increase of people in contact with mental health, learning disabilities and autism services who were admitted as an inpatient between the years 2016-2019.
Although there are plans to increase NHS staff, a performance analysis in the HEE Annual Report and Accounts in 2017/18 says: “The NHS will need more than 21,000 more mental health staff to increase patient access to services and simply adding more training posts will not be enough… increased investment in the development and re-skilling of existing staff is vital”.
Amy Crowther says that when she visited GPs about her condition she was, “referred to a psychosexual clinic.” She adds: “You only get six [therapy] sessions. I was told to get some dilators and do pelvic floor exercises”.
Lisa Mackenzie says: “Many women have said their GP so flippantly will say have a glass of wine, relax and you’ll be fine. Young girls are told you just need to have more sex, or you'll grow out of it”.
Is a Quickie solution worth the gamble?
Charly, who wishes to remain anonymous, found that psychosexual therapy was not suitable for her and opted for an unusual, alternative treatment. She says, “Botox is inserted into vaginal muscles under general anaesthetic.” The procedure cost £600 and the removal of a part of her hymen cost another £300.
The procedure wasn’t without complications she says: “Your anus can become paralysed or lose muscle memory. I’ve been dependent on using laxatives to go to the toilet since having the treatment a year ago, it’s been a life changing side-affect”.
Botox relieves consistent clenching and penetrative sex may be possible, but risks can be severe. The total price is around £3200, it is rare to obtain in the UK. Charly says: “Botox should be on the NHS for patients who suffer from vaginismus as options like therapy don’t deliver sufficient progress”. Aaliyah Harris conducted a survey in the UK, Canada and US consisting of over 100 participants aged 15-65 to investigate their understanding about vaginismus.
Results show that 73% of respondents had not heard of the condition and an overwhelming 97% said they had not learned about it in sex education at school.
Shhh! You can’t say sex out loud
Sex in British culture tends to be a hushed up topic and Brits love to shy away from subjects that make them uncomfortable. But why should learning about reproductive organs and sexual anatomy be difficult?
Limiting sex to one physical act excludes other intimacies. Hazel Mead, feminist and illustrator collaborated with the Vaginismus Network to show there is more than one way to orgasm. Her informational artwork includes role play, sexting, ASMR, watching porn as a couple and activities alongside PIV (Penis in Vagina).
The Diary of My Broken Vagina is a Comedy Blap released in December last year, available on Channel 4’s All 4 and YouTube. Written by Fran Bushe, the sitcom is based on real diary entries and looks at how some women cope with sexual struggles. It’s witty, bold and enlightens viewers about vaginismus.
Vloggers and radio presenters chatting about the stigma associated with sex is becoming common. The Unexpected Fluids is a BBC Radio One podcast hosted by Alix Fox and Riyadh Khalaf that encourages listeners to speak about their real-life sex stories.
Lisa Mackenzie dated her partner for eight years without ever speaking about her vaginismus. She says: “As two young people seeing everyone around us having sex made us feel embarrassed”. Now, she says speaking freely about vaginismus has made dating simpler.
For Amy Crowther, she explains, “I didn't have a boyfriend until I was 28 and I think vaginismus was a big part of that”. Dating with vaginismus is a love triangle between you, your partner and a third wheel. “I definitely want to have children and vaginismus concerns me,” she adds.
There is hope as social hubs like the Vaginismus Network provide a platform to connect people to learn about sexual health. But these communities cannot be expected to shoulder the responsibility alone and public healthcare services must do more to provide better treatment for patients with vaginismus.
This investigate article was originally written for a group project that I worked on in my final year of University. Sorry Not Sorry magazine is unapologetic about sex and relationships. Below are images of the printed feature spread.
