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Vaginismus and Infertility

What is Vaginismus?

In a part of the body that contains so many nerve endings and sensory receptors, it’s no surprise that some people experience pain. There are different vulvar and vaginal pain conditions, and vaginismus is one of them. It’s a muscular spasm of the vagina that precludes entry by a partner or an object. Women with vaginismus often experience pain and difficulty with intercourse, tampon or menstrual cup use, and medical exams.
This helps to understand the underlying mechanism of vaginismus, but unless you’ve experienced the condition or seen it firsthand, it’s difficult to understand. As a pelvic health physiotherapist I think of the muscles lining the vaginal canal as a series of doors. Each muscle layer surrounds the canal as you get farther into the pelvis. Some readers will be familiar with the opening sequence of the Get Smart television show, where the main character (a secret agent) has to pass through a number of doors to gain entry into a highly secured facility. He eventually reaches a telephone booth that allows him to reach his final destination. Presumably, the doors open because they recognize him in some way and they grant him access.
In vaginismus, the “doors” interpret a threat and they refuse to open. We can try to pry or force them open, but they will only learn to increase the resistance the next time. The reality is that the vaginal muscles are doing exactly what they should be: protecting and reacting. It’s only in recognition of this fact that we can begin to work with the condition.

The Face of Infertility

This blog is all about exploring different perspectives on health and wellness. The aim is to inspire new thoughts and encourage conversations. By pushing the existing boundaries, we include more women in the day to day discussion of healthcare.

Until very recently, infertility was a topic that lived in the shadows. Couples continue to struggle on their own and feel that they can’t share their experiences. However, celebrities are now sharing their stories and shedding light on their inability to get or stay pregnant. Their tales are magnified as social media allows others to step into the same light. It’s not easy to find the words… When someone else discloses an experience similar to one’s own, it can inspire a “like” or a “share” as a simple demonstration of togetherness.

We’ve heard of the miscarriages of Priscilla Chan and the IVF of Michelle Obama. These are brave women who have changed the conversation around fertility.

Still in the Shadows

If it’s now easier for women to talk about miscarriages and IVF, who is still in the shadows? One group we don’t discuss is the women who can’t have children because they can’t have intercourse. Sex is supposed to be fun, enjoyable, pleasurable. If nothing else, it’s certainly supposed to be the means of reproduction. Acknowledging that some women don’t have children because of vaginismus requires us to talk about something that brings on much more discomfort than infertility: sex and pain.

Why would sex be painful? It’s hard to imagine benign or even positive reasons. It can be painful because of trauma, fear, apprehension, and so much more. It can be painful because it was painful the last time; the body is very good at protection and survival. And because we’re not good at talking about pain down there, we leave these women in the shadows.

Bottom Line

As a physiotherapist there’s nothing I can do about many of the causes of infertility. However, vaginismus and pelvic pain are well within my realm. The first step is to talk about this condition within the fertility discussion and bring women out of the dark corners.

If you think you may have vaginismus or another pelvic pain condition, there is help. Reach out in any way you feel comfortable:
By e-mail

By phone
In person

If you don’t have vaginismus, you can help by talking about it. You never know who in your social circles will benefit. If you’re lucky, a baby might come into the world and a woman might be able to enjoy a physical relationship! Share this article with others and spread the word.


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