The way to cure vaginismus is to talk about it

Aiema Tauheed, Kolkata

FOR four years a healing programme conducted online has been helping Indian women deal with a little-understood condition called vaginismus which makes them involuntarily freeze when they are at the point of having sex.

Like the eye blinks to keep out even a speck of dust, the vagina closes down and becomes a wall at the time of penetration. The buttocks and thighs also contract.

Dr Taru Jindal, a gynaecologist who conducts the course, says it has been attended by 500 women who couldn’t understand their situation and found it difficult to explain it to their partners.

Making it more complicated, vaginismus does not result from lack of desire. So, there can be foreplay, intimacy and a peaking of the urge for sex, but a complete shutdown at the time of consummation.

Dr Jindal herself suffered from vaginismus. Though married to a psychiatrist and batchmate, it took her seven years to deal with her condition.

She says since talk about sexual dysfunction and sex itself is uncommon, women with vaginismus, of whom she was one, don’t seek help and end up taking the blame for deteriorating relationships.

Dr Jindal estimates that in any society 10 to 15 percent of women have vaginismus. But there is little recognition of their number. Even if women do want help, physicians who can diagnose vaginismus and treat it are tough to find. As a result, women live under its burden.

It is also not restricted to sex, but any kind of vaginal penetration such as a gynaecologist’s finger, an ultrasound probe or a tampon.

 “It’s very important to focus on the fact that it is involuntary because a lot of men feel that women are doing this deliberately or they are not trying hard enough, which is not true. It is beyond one’s control. Vaginismus is not the woman’s fault,” says Dr Jindal.

“Funnily, many gynaecologists who see vaginismus patients, given its relation to the vagina, are often not trained to treat it. Despite 12 years of medical education and an MD in gynaecology, I don’t remember ‘vaginismus’ being covered in our textbooks. On the other hand, psychiatrists, who study it in their training, usually lack practical experience with the condition because they don’t see many patients with it,” she explains.

She herself encountered conflicting advice from various specialists. Mental health professionals focused on trauma, while gynaecologists and physiotherapists emphasized physical treatment like pelvic floor relaxation. This disjointed approach, combined with the emotional burden of shame, made it challenging for her to find effective treatment.

In 2015 she quit her work to focus on her recovery. She researched extensively and developed a comprehensive healing plan. In around four weeks, she healed her vaginismus herself. Determined to help others suffering from this condition, she took this up as a cause.

In 2020, Dr Jindal launched a two-month online vaginismus healing programme in partnership with Proactive for Her. This programme, based on her personal four-step formula, integrates both mental and physical aspects of treatment. In January 2024, the programme was recognized as the ‘Best Digital Healthcare Project’ at the 3rd Digital Health Awards in Delhi.

“Social media has been a game-changer as far as treatment is concerned,” notes Dr Jindal.

Earlier, women could only google “painful sex” and scour the internet to find a diverse range of search results. But vaginismus is a specific type of sexual pain. Knowing the term is crucial for proper treatment. Traditional healthcare systems can be dismissive of it. However, Instagram has opened doors to a wide audience, allowing posts about vaginismus to reach many people. This visibility has helped individuals identify their condition and seek help through Dr Jindal’s programme.

“Vaginismus direly impacted my marriage. After seven years, we were on the brink of separation when I focused on treating my vaginismus,” Dr Jindal says. The condition can be a home-wrecker, leading to frequent arguments with a partner. Initially, the partner may try to be supportive but over time frustration can build. This can transform the relationship from one of intimacy to that of mere roommates. The impact on reproductive life is also significant, as the desire for parenthood may be hindered. In a desperate bid to become pregnant, couples might turn to IVF. “Personally, I experienced these challenges, and as a gynaecologist who delivers many babies, it was a constant reminder of my own inability to overcome this issue.”

While sexual frustration is a direct consequence, the impact goes far beyond the bedroom walls. In Indian culture, a woman’s identity is often linked to her ability to procreate, provide sexual pleasure, or nurture children. Vaginismus challenges this very core of that identity, as it prevents consummation of the marriage or relationship.

Devanshi, one of 500-plus women who overcame vaginismus through Dr Jindal’s programme, says, “The biggest impact of not understanding what was happening or where I was going wrong was a severe drop in self-esteem and a deep sense of guilt for not fulfilling my role in the marriage.”

Seeing others able to engage in sexual activity can lead to feelings of inadequacy and self-doubt, causing a loss of self-confidence and self-esteem. This often leads to irritability, sadness, anxiety, and depression.

 

THE REASONS

Yet Dr Jindal called this condition a protective response. But why would the body perceive penetration to be a threat? There are various causes identified by Dr Jindal, especially in the Indian context.

The foremost cause is the widespread belief that sex is painful. Many women hear stories about the first night being painful, involving bleeding and hymen rupture. Such narratives about pain and sex being unsafe become deeply ingrained in our system. Thus, the body responds by contracting, as it senses danger and signals that it is not safe.

The second is shame. In India, sex is approached with great conservatism. Premarital sex is disapproved of. This creates a scenario where something that has been considered morally illegal for the first 25 to 30 years of life must suddenly be embraced and enjoyed overnight. Such a drastic shift is challenging for the body and mind to reconcile, leading to vaginismus.

The third reason is bad touch. Abuse while growing up can leave an indelible mark that continues into adulthood. Instances of sexual violence such as the Nirbhaya case of 2012 have been etched into the psyche of many young girls with no sex education. Sex and violence have been conflated.

“When we treat people now, the first thing they mention is the Nirbhaya case. Its impact was so profound that it has led many to instinctively view anything sexual or penetrative as unsafe,” says Dr Jindal. She proceeds to explain, “The severity of the initial stimulus does not necessarily determine the extent of its impact. The crucial factor is how the individual processes the experience. It becomes essential to differentiate between violence and sex. Reframing the understanding of sex as pleasurable, painless and consensual rather than as dangerous.”

Another reason is the impression that sex comes with painful consequences such as painful pregnancies, diseases and unwanted foetuses. Some people who hear of such stories come to see sex as actually being dangerous.

Thus, a combined mind-and-body approach is crucial for effective treatment. It should address both emotional and physical healing. Emotionally, it involves revisiting and healing past trauma. Physically, it focuses on pelvic floor relaxation to ease the tension in the vaginal muscles. This includes vaginal training with dilators of increasing sizes, starting small and gradually progressing, to help patients learn to relax while inserting them.

Vaginismus often decreases libido and desire. Initially, many women with vaginismus experience high levels of desire, but repeated failures and disappointments with penetration can cause their body to shut down desire as a protective response. The good news is that it is just a temporary reduction of desire because of loss of hope.

“Don’t waste time. Come to us for help,” says Dr Jindal’s message to anyone who thinks they might be suffering from this condition. One can reach out to her at @tarujindal on Instagram.

It is not as though everyone gets cured. Dr Jindal’s success rate is 51 percent. It is because of the complexities of treating someone with vaginismus. Trauma apart, not everyone is willing to adopt vaginal dilators and do pelvic floor exercises with the same dedication. Successful cases take six to 12 weeks.

Proactive for Her offers a queer-friendly, inclusive and judgement-free space to heal. The programme avoids using terms like “marriage” or “husband”, opting instead for  “relationships” and “partners” to be more inclusive. They also ask for and use participants’ preferred pronouns, having treated queer folk.