GUEST POST: Vaginismus; One Size Does Not Fit All

We're delighted to have a guest post from Aoife Drury, Psychosexual and Relationship Therapist, giving a really helpful overview of the different ways vaginismus can impact... 

When I began my training as a Mental Health Nurse almost 12 years ago I worked with a variety of people with both physical and mental health diagnoses. After all these years I am still saying the same thing, irrespective of the diagnosis presented; that we cannot generalise our treatment and support for our clients. This is simply due to the fact that we are all individuals, therefore the symptoms, presentation and treatment can, and will greatly vary. It is not ‘one size fits all’, it’s about individuality. This is no different with vaginismus. Vaginismus manifests in various ways for women and the emotional and physical symptoms will be experienced differently.

Firstly there are different forms of vaginismus and symptoms vary between individuals.Vaginismus may be primary (i.e. lifelong), or secondary (occurring after a period of normal sexual function). It may also be global (occurs in all situations and with any object) or situational: may only occur in certain situations (pelvic floor, using a tampon).

Secondly Pain can range from mild to severe, and it can cause different sensations. People experience pain differently, and have a different threshold. For one person they may describe the pain as a minor discomfort, however someone else may experience  burning with tightness sensation. What matters most is that you are experiencing pain and that in itself is unpleasant and needs to be treated. Please do not diminish your pain if you read or hear something different from another woman. Your pain is as important as anyone else.

Thirdly, vaginismus can result from emotional factors, medical factors, or both. There’s no single cause to vaginismus, it can be vague, or specific.

Vaginismus can be caused due to a variety of reasons women may have experienced a trauma, they may have been struggling with a UTI which has caused sexual anxiety, fear surrounding sex due to childhood and upbringing, your first sexual experience. The physical reasons can also be physical reasons, like complications from pelvic trauma or cysts, a tear, changes following childbirth, menopause, medication. These lists may seem overwhelming, but in fact the underlying issue tends to be similar; anxiety, fear and pain. This is what joins women’s experience together while also allowing you to remain unique.   

Finally, the best treatment methods vary from individual to individual.

When I see clients I am very aware that the types and lengths of treatment are different for every woman. As a therapist I utilise many methods to support women suffering with vaginismus. I draw on everything from Cognitive Behavioural Therapy (CBT), psychosexual education to address any beliefs about sexuality, the anatomy of the vagina. I work with mindfulness and guided visualisation. Finally exercises that the client can do at home such as non-penetrative sexual touching gradual use of dilators and integration of their partner if they are in a relationship. All of this can be changed and altered taking into account; the client's past, their reservations and who they are as a person. Including but not limited to; trauma work, internalised anxiety or referrals to a pelvic pain expert.Of all the pain conditions, Vaginismus is the most successfully treated in the shortest amount of time There’s no set path to recovery that will work for all women, with patience and the right treatment for you it will gradually all fall into place.


Aoife Drury