Understanding vaginismus - new study examines causes and treatments

A new study on vaginismus by Dr. Maria McEvoy from Dublin City University’s School of Nursing, Psychotherapy and Community Health has found that a significant challenge for women themselves and helping professionals is how to define vaginismus and the profound effect this has on treatments offered to women and couples. 

This is the first Irish study in forty years to look at the psychosocial factors that contribute to vaginismus and it incorporates biological, psychological and social aspects in order to explain the myriad of factors that can contribute to the vaginismic response and suggests a holistic approach to treatment.

In Northern Ireland, vaginismus has been estimated to be the second most prevalent female sexual difficulty presenting at clinics. 

What is vaginismus?

Vaginismus is the experience of being unable to have penetrative sex and manifests as an involuntarily tightening of a woman’s pelvic muscles, preventing penetrative sex. As a clinical phenomenon, it is associated with high levels of distress for those affected and it can have a profound impact on how a woman feels about herself, on her partner, and on their relationship. Research on how women and couples experience vaginismus has been very limited.

Rates and diagnosis

It is also very difficult to establish rates for vaginismus for a number of reasons. 

First, most studies are based on clinical populations, that is, women who attend clinics for help. It is likely that the prevalence rates in the general population are higher. Second, vaginismus tends to be a very secret hidden problem because of the shame and stigma attached to sexual difficulties and sex in general. Thus, secrecy and guilt prevent identification. Third, the association between sexual abuse and vaginismus may exacerbate experiences of shame, which prevents women from seeking help, although few studies have actually demonstrated the link between vaginismus and sexual trauma.

Dr. Maria McEvoy, author of the study said 

“A lack of knowledge about vaginismus from health care providers and in the general population leads women to believe that their experience is unique which contributes to feelings of shame and helplessness. Vaginismus is a common sexual difficulty that can be effectively treated when appropriate help is provided by knowlegeable, trained practitioners who can support women and couples to understand and resolve vaginsimus.”

Understanding vaginismus 

Based on interviews with couples who have experience of vaginismus and helping professionals, Dr McEvoy developed a theory that helps us understand the condition.  

Her study findings suggest that the difficulties associated with vaginismus may have their roots in childhood and may be associated with the experience of negative and frightening messages regarding sex and pre-marital pregnancy. In many cultures, including Ireland, a daughter’s sexual reputation can be perceived to have wider implications for the reputation of the family leading to feelings of fear and shame being associated with sexual relationships. These feelings of fear and shame can manifest physically, as in the case of vaginismus, as an automatic tightening of the vaginal muscles whenever intercourse is attempted, and this may be interpreted not only as an attempt at physical protection of the body but also as an emotional protection from the shame associated with sexual behaviour. The shame of these early messages can persist for many years and impact relationships.

Couples in this study reported that understanding and resolving vaginismus is a process that can take time so a feeling of connection, understanding and support from the health care professional was vital to the success of any treatment.

Professionals, including psychotherapists and medical practitioners, noted that the resolution of vaginismus will be a unique journey for every woman and couple and it is incumbent upon healthcare professionals to work with other professionals to provide a multidisciplinary response rather than a one-size-fits-all approach to its resolution. 

All participants noted that a major barrier to accessing help was the cost. In Northern Ireland many psychosexual services are available free of charge from the National Health Service, but in the Republic, there are limited specialist services available in the public health service; the financial burden of resolving vaginismus can be considerable for those affected. Sexual health and well being is an important component of individual and relationship satisfaction and support should be available for those whose wellbeing is affected by the experience of vaginsimus.

Further information about the study and about support services are available at www.vaginismusresearchireland.com