On her podcast "Workin' On It," Meghan Trainor revealed she has a medical condition that makes sex painful.
“I was told I have something called (vaginismus),” Trainor said. “I thought every woman walking around was always in pain during and after sex.”
Pain during and after sex is never normal, says Sara Reardon, a pelvic floor physical therapist known as “The Vagina Whisperer” on social media. But she says there are good treatments for vaginismus that can make sex fun and other activities easier. People experiencing vaginismus have real pain that often is debilitating.
“Some of the descriptions we’ve heard are: ‘It feels like my vagina is tearing.’ ‘It feels like my vagina is ripping, burning.’ ‘I feel like something’s hitting a wall.’ These are the real descriptions of the discomfort that people are experiencing,” Reardon, owner of NOLA Pelvic Health in New Orleans, tells TODAY.com. “The ripple effects of this can really infiltrate so many aspects of our lives and it’s not even just about sex. It’s really about the quality of life of a woman.”
What is vaginismus?
Vaginismus occurs when the pelvic floor muscles spasm involuntarily when something attempts to penetrate it, Reardon says. Fingers, tampons, menstrual cups, speculums, other medical equipment or penises being inserted cause muscle tightness that, in many cases, halts penetration.
“It doesn’t allow entry into the vagina,” Reardon says. “It’s often described as it feels like something’s hitting a wall.”
About one in five women experience it, she adds, but she and other experts think that’s likely undercounted. Many people, like Trainor, do not realize that pain with sex is abnormal.
“These are underreported conditions that are under-researched,” Reardon says. “There’s not a lot of attention being paid to these conditions.”
When can vaginismus occur?
In many people, vaginismus starts in their late teens when they first have sex, try to use a tampon or menstrual cup or have a pelvic exam. But it can occur at any time even after years without problems.
Symptoms of vaginismus
Symptoms of vaginismus include:
- Pain during penetration.
- Pain during sex.
- An inability to have sex at all or have something inserted, such as a tampon or finger.
Why does vaginismus occur?
“It’s typically a multifactorial situation,” Reardon says. “ So, we can think of our pelvic floor muscles like any other muscles in our body — sometimes they get tight and tense.”
Sometimes, people carry their tension in their pelvic floor making these muscles sensitive and achy. Though people who have experienced trauma — not just sexual trauma — are more likely to experience vaginismus. It can also occur after chronic infections, such as repeated UTIs or yeast infections, or following childbirth “where there may be some scar tissue.”
According to The Cleveland Clinic, people more likely to experience vaginismus include:
- Those with anxiety.
- People who have injuries from birth such as a tear.
- Those who've had pelvic or vaginal surgery.
- People who have been sexually assault or abused.
Reardon says there’s a “psychosocial component” that commonly contributes to it.
“Oftentimes we’re not educated about this part of our body and if we’re anticipating pain or discomfort, our body tenses up in response,” she says. “That causes discomfort with something inserted and then you get into this cycle of ‘Oh my gosh, it’s going to hurt because it hurt last time.’”
People from strong religious background experience vaginismus commonly, Reardon says.
“(People) often have been told that sex is bad, or you shouldn’t do it,” she says. “If you’re waiting to get married and they try to have sex for the first time it’s like the switch doesn’t flip, like ‘Oh, this is OK.’”
Treating vaginismus
There are many ways to treat vaginismus and Reardon says allowing people to talk about it without judgment makes a tremendous difference.
“One of the biggest things is providing a space for people to talk about this,” she says. “The first (thing) is helping people find a place or a provider that can adequately support them.”
She encourages people who have been told that pain during sex is normal to find a different provider because they are being dismissed.
Doctors sometimes prescribe vaginal inserts of medications, such a baclofen and valium, to relax the muscles, or they can inject Botox into the pelvic floor muscles to address vaginismus. Reardon says these treatments should be used in conjunction with pelvic floor physical therapy because the medications only work for a limited time. A pelvic floor physical therapist will try to uncover the origin of the issue first before coming up with a treatment plan.
“We do an assessment,” she says. “If it’s a muscular issue, we work with women to help them relax their pelvic floor muscles through a variety of breathing techniques to relax the overall nervous system.”
Therapists might also recommend yoga poses that help to “stretch and lengthen” the pelvic floor muscles and perform internal massages of the pelvic floor muscles, where the physical therapist puts pressure on the internal muscles much like one would receive during a back massage, for example. Reardon says the “gold standard” treatment for vaginismus involves vaginal trainers or dilators.
“You teach them how to insert something into the vagina and they no longer see it as a traumatic or painful,” she says. “It’s desensitizing those tissues but often then they start to connect with ‘Oh something in the vagina doesn’t have to be painful.’”
With this therapy, people generally start with smaller sizes, about the size of a pinky finger, and work their way up so they can get tampons, speculums or a penis into their vagina without pain. While many people might think Kegel exercises would help, they are not useful for people with vaginismus.
“This is a condition where you have too much tension in your pelvic floor and Kegels would actually make that situation worse,” Reardon says.
She encourages people to seek help if they experience pain during insert because it can get better.
“Sex is really supposed to be something that’s pleasurable and enjoyable for both parties,” Reardon says. " It shouldn’t be something that’s just tolerated."