15th September is globally celebrated as ‘Vaginismus Awareness Day‘. Though it is one of the most common female sexual dysfunctions (FSD), most people are not aware of this condition.
Vaginismus is known as the inability to achieve vaginal penetration or the experience of undergoing severe pain during sexual intercourse. The reason for the extreme pain is the continuous, involuntary contraction of pelvic muscles in the outer one-third of the vagina.
The vaginal muscles, which are usually fully under the control of the individual, contract strongly during sexual intercourse just before the penis enters the vagina, making penile penetration nearly impossible. Vaginismus is not only caused during sexual intercourse but also while inserting things like tampons.
There are three different forms of vaginismus, namely primary, secondary, global, and situational. Individuals experience primary and global vaginismus during their first sexual intercourse only, which signifies that the pain was always there. While a person may encounter secondary vaginismus after they have already experienced normal intercourse, situational vaginismus only occurs in specific situations.
There is no defined cause for vaginismus. It can be caused due to varied reasons such as fear, depression, shame, relationship difficulties, self-image, anxiety or childhood trauma.
Poor sexual health literacy, guilt about sexual pleasure, highly restrictive values, and childhood sexual violation/abuse are common predisposing factors in the presentation of lifelong vaginismus, whereas untreated local organic pathologies and ongoing relationship conflicts are seen as the most perpetuating factors for vaginismus.
All individuals with vaginas experience some kind of pain in the initial stage during sex. But those experiencing extreme pain tend to assume that it is normal. Most people do not seek medical help for this as they think it is common to experience pain during sex.
The socio-cultural normalisation of pain in females during sexual intercourse is one of the key reasons leading to the lack of knowledge about vaginismus.
We are full of misconceptions about sex and the main cause for that is a lack of comprehensive sex education. Sex itself is a stigma in our society, let alone the topic of sexuality. Be it a male, female, or an individual of any gender, they must be sensitised and exposed to sex education. Sex education in schools is a significant step that should be taken to build awareness about sex and related conditions like vaginismus.
Although vaginismus hurts an individual’s mental and physical health, it is an extremely less talked about condition due to the social taboo around sex. When it comes to talking about female sexuality, our society mostly chooses to be silent. Female sexual health is never really a priority for us.
According to a report by The New Indian Express in 2014, vaginismus was cited to be a major reason for divorces in the state of Kerala. One such case was of Zakeena* who was married to Aziz* for over 15 years. Everything was good with the couple except that they had been leading an unconsummated marital life.
The pressure from their family and society to birth a child started bothering them and due to the stigma around sex in India, it became hard for them to explain to anyone why Zakeena remained a virgin even after so many years of marriage.
There are many such stories where both man and woman in the relationship are not aware of vaginismus even after significant years into the relationship. Couples rarely seek medical treatment for the condition. Hence, it’s highly important to not only talk about sexual health problems like vaginismus but also to create awareness about sexual well-being.
As stated by Dr. Pramodu (renowned sexologist in Kerala) in The New Indian Express, “Around 90 percent of women suffering from vaginismus have not understood the cause of the trauma and those who know do not want to share due to societal stigma and isolation. Consequently, many marriages turn out to be failures”.
In the UK, 1 in every 500 women suffers from vaginismus as per studies, but there is no reliable data on the number of people suffering from vaginismus in India, even though vaginismus is a serious sexual dysfunction.
However, as per a study by the Indian Journal of Psychiatry, the percentage of vaginismus diagnoses for women who come to sexual dysfunction clinics ranges from 5 to 17 percent. Women often hesitate to speak about their sexual experiences and feel guilty about their inability to have intercourse. This is one of the reasons for not having proper data on vaginismus in women.
Moreover, women also presume that it can bring shame to their life and family because of the societal pressure to have children and silence about sexual barriers. Vaginismus can affect the mental well being of individuals as they develop feelings of shame and low self-esteem due to their guilt over the “inability to provide sex”.
Although vaginismus is treatable, people who are not aware of the condition do not know that it is just like any other medical condition which is manageable through medical interventions. In our country, the lack of public awareness about vaginismus, along with the shame and fear of judgment by society makes it difficult for people to discuss it among themselves or with a doctor.
By opening up about sexual-well being, and facilitating a safe atmosphere for conversations, conditions like vaginismus can be addressed, treated, and understood better.
On this Vaginismus Awareness Day, we must pledge to be more open about our bodies and sexual experiences, so that individuals do not suffer by themselves in silence bearing the pain and trauma of problems like vaginismus. Mainstreaming the discussion around sexuality can solve many problems and pave the way for a healthier life and a better society.
*Names changed to protect privacy