- Vaginismus, a condition where vaginal muscles involuntarily tighten during penetration, often stems from cultural stigmas, psychological factors, or past trauma, making intimacy challenging for many women.
- Women seeking treatment frequently face societal shame and a lack of empathy from healthcare providers, but a multidisciplinary approach involving physical therapy, counseling, and supportive partnerships can significantly aid recovery.
- Raising awareness and normalizing conversations about women’s health and intimacy could help reduce isolation, allowing women to seek help without stigma and empowering them on their journey toward healing.
When Laiba, a 29-year-old from Karachi, consulted an experienced gynecologist, she was met with harsh words: “Mark my words, your husband will leave you.”
Now 34, Laiba recalls the encounter vividly, not so much for the words themselves but for the severe lack of empathy and the shame cast upon her.
“It wasn’t just what she said,” Laiba remembers. “It was the tone, the intended shame.” Frozen and unable to respond, she left feeling vulnerable.
The doctor’s attitude lingered with her. “She told me, ‘A woman who can’t even fulfill her basic responsibilities… Stop acting like a schoolgirl,’” recalls Laiba.
It took her almost two years to gather the courage to see another gynecologist. “I left in tears,” she says, recounting the ride home with her mother who tried to reassure her. Though she knew her husband would stand by her, what hurt was the mental toll of reaching out on an issue clouded with shame.
The second doctor’s reaction was vastly different. She listened to Laiba’s concerns and, after an examination, diagnosed her with vaginismus. “It sounds strange, but I was relieved. Knowing there was a term for what I felt—and that I wasn’t alone—was validating,” Laiba says, tearing up.
Laiba’s diagnosis, vaginismus, is a condition in which the vaginal muscles involuntarily tighten up during attempted penetration, causing pain and discomfort. According to Dr. Mala Jitendra Shahani, a Karachi-based gynecologist, the condition occurs without conscious control and is a reflexive response that complicates intimacy. “It’s uncontrollable, triggered only during penetration attempts,” she explains.
What is Vaginismus?
Vaginismus is largely a psychosomatic condition, Dr. Shahani clarifies. The body, anticipating pain, reacts with a muscle spasm. Cultural attitudes around sex can contribute to this issue, as women often receive negative, fear-based messages about intimacy from a young age.
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Struggle of Living with It
Dr. Shahani frequently meets women struggling with vaginismus. They may have no issues using tampons or menstrual cups, yet involuntary contractions persist during intercourse. This condition, she notes, is often misunderstood due to the stigmatized nature of its causes and symptoms.
Dr. Omema Akhtar, a gynecologist at Jinnah Postgraduate Medical Centre, says that while there’s no exact data, nearly one in two patients she sees has some degree of vaginismus. “It’s a common but treatable condition,” she notes.
Dr. Akhtar likens vaginismus to erectile dysfunction, emphasizing that the condition is beyond the individual’s control. She reassures patients that it isn’t their fault, explaining that this involuntary response doesn’t reflect a failing on their part.
Vaginismus affects an estimated one to seven percent of women worldwide, though prevalence varies widely across regions. A study in India found that up to 28% of surveyed women experienced primary vaginismus. Data on the condition remains scarce in Pakistan, but based on her experience, Dr. Akhtar estimates that one in twenty women has vaginismus.
Pakistan’s cultural silence around sex and intimacy often exacerbates this issue. Samia Khan, a licensed sex therapist in Wisconsin, explains, “Cultural and religious norms shape how people perceive intimacy.” She notes that societal conditioning, which frames intimacy as negative, leads individuals to internalize these beliefs, and that dissonance can later manifest as physical resistance and pain.
Trauma can also intensify these reactions. Misha, a 36-year-old, recalls her struggles with intimacy following childhood abuse. Growing up, Misha was made to feel responsible for the abuse she endured. Suppressing this trauma, she eventually married but found herself unable to be intimate. Diagnosed with vaginismus in the U.S., she’s grateful for the support she received after moving there, as she feels it would have been nearly impossible to access similar help in her hometown.
Not every case of vaginismus stems from past trauma, as Laiba’s story illustrates. Anum, 27, was diagnosed by a gynecologist who assumed abuse was at the root of her condition, a conclusion she knew to be incorrect. Anum eventually found a doctor who validated her experience without unfounded assumptions.
For many, online searches offer an introduction to their symptoms. Ayesha, an A-level math teacher, began researching “fear of penetration” and discovered the term “vaginismus,” along with a global community of women facing similar issues. However, the cultural disconnect she felt from these communities underscored her desire for local, relatable support.
Vaginismus treatment often includes pelvic floor physical therapy and psychotherapy. Samia Khan emphasizes that pelvic floor therapy, which targets muscle relaxation, can complement psychological counseling, especially for patients with trauma. Dr. Shahani explains that treatment for vaginismus is multidisciplinary, involving physiotherapists, psychologists, and, at times, medication. She often uses vaginal dilators, starting with small sizes and instructs supportive partners to be involved, which can ease the process.
A supportive partner is crucial, Dr. Akhtar notes, as vaginismus treatment is often a collaborative journey for couples. Without emotional and mental support, recovery can be challenging. “Some women can use dilators independently but struggle with intimacy,” she explains. The treatment involves both partners, as understanding and participation are essential for overcoming the condition together.
Hannah, now 33, reflects on her experience of early marriage and divorce, which she attributes to her unpreparedness for intimacy and her lack of understanding about her own body. Married at 21 to a family friend 11 years older, she was traumatized by her wedding night experience and ultimately divorced six months later. Now, she remains single, feeling that her limited understanding and trauma were never fully addressed.
Women’s health issues, especially those related to reproductive health, are often understudied and stigmatized, leaving conditions like vaginismus poorly understood and inadequately treated. Many still navigate these conditions in silence, isolated by cultural taboos and a healthcare system that lacks the resources and understanding they need.
Qurat, 31, has made strides in her journey with vaginismus, sharing that she recently underwent a pap smear, a major personal milestone. She reminds herself, “Everyone’s journey is different. I may struggle, but this doesn’t define my worth as a woman or partner. If I don’t show myself kindness, no one else will.”
The path forward involves a deeper understanding of vaginismus, support from both partners and healthcare providers, and a cultural shift toward open discussions about women’s health. This shift would help countless women shed shame and find strength in shared understanding.
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Source: Dawn