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GINA Blog: Vaginismus and the media

Like all eager, anxious teenage girls, one of the most important things in my life was sex. And like all of us, I was lied to.

For one, I thought all my sexual partners would look like Zac Efron or Megan Fox and we would fall passionately in love and engage in romantic, passionate love-making on a bed covered in rose petals.

Somehow, there would be a flattering backlight involved and one single bead of sweat.

But what about the awkward or uncomfortable aspects that come along with the birds and the bees? And what happens when things don’t go to plan?

Painful penetrative sex isn’t something we are shown in mainstream media, so I had no idea how much pain was “a normal amount”, (hint: sex shouldn’t be painful), or if and when I should do something about it.

Conditions like vaginismus, which cause pain during any form of penetration, can affect up to 17 percent of people with vaginas. That’s more than three in every 20 vagina-owners.

Now, spend a moment thinking of all your favourite characters.

Why didn’t we see Buffy struggling to use a dilator? Why did we miss out on the Sex and the City episode where Miranda has to wear a pad at the beach because she can’t use a tampon?

Why were we deprived of seeing Blanche or Dorothy from The Golden Girls dislocate a hip while doing pelvic floor exercises? We were robbed!

We can’t be what we can’t see

Recently, mainstream media has sought to bridge the gap in representation of vaginal sexual dysfunction.

The season two finale of Sex Education marked the first time I ever saw vaginismus, in all its gritty and awkward glory, depicted on the small screen.

We meet Lily (Tanya Reynolds), a super-horny, space-obsessed high school student intent on having sex with her boyfriend for the first time before graduating. But Lily is “betrayed” by her vagina. It’s not a matter of desire, because Lily desperately wants to have sex. She feels disempowered, demoralised and alienated (no pun intended).

“It’s like my vagina has lockjaw,” she explains to her psuedo-sex-therapist classmate, Otis.

Similarly, the show Unorthodox also brought vaginismus to the masses.

Protagonist Esty finds herself in opposite circumstances to Sex Education’s Lily. Without any understanding of her body, sex, arousal and female pleasure, Esty’s sexual experiences are plagued by pain, fear and judgement. Rather than engage in sex with someone she loves, Esty’s community expects her to reproduce with the stranger she just wed.

Though dark and occasionally depressing, Unorthodox gives an insight into what can happen when people don’t receive a comprehensive and inclusive sex education.

For people with vaginismus, seeing a storyline that accurately portrays the condition in popular culture can be incredibly affirming and validating. Watching someone grapple with the same frustrations, troubles, and triumphs can help ease feelings of isolation.

Feeling comfortable enough to disclose the condition to loved ones isn’t easy, especially if you’re faced with the prospect of having to educate them about it too.

Seeing your struggles reflected in popular culture can also go a long way to reduce stigma and to raise awareness about such an under-funded and under-researched condition.

Vaginismus is real, it’s treatable and statistically, it also affects someone you know. So why are we concealing it under a cloak of silence?

We need to see it on our screens, we need to talk about it with our friends and we need to rant about it on Reddit.

The message is, you’re not alone.

Cassandra T.

Cassandra is a writer, a feminist and a former lifestyle journalist.

Do you have a story you would like to share? Send an email to hello@ginaapp.com with the subject line ‘GINA Blog’ and we will get back to you.

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GINA Blog: Tampons. Ugh

 

I was 14 years old the first time I was shamed for not using tampons. Standing in the school bathroom, bleeding and asking a friend for a pad, she came back with a tampon ‘sorry I don’t use pads, just use a tampon like everyone else’.

At 16 I felt less alone when I found myself on the phone with my best friend who for some reason had called me (a tampon novice) to ask for help. She had locked herself away in the bathroom and couldn’t get it in.

Thankfully my mum overheard the conversation and intercepted the phone, walking my friend calmly through the steps. My friend called back 15 minutes later, telling me she had abandoned the whole operation and would just wear a pad. So maybe it wasn’t just me?

At 19 I revisited the whole challenge, determined to use a tampon. I had just started having sex and if I could fit a penis up there I could definitely fit a mini tampon which was like 1/10 of the size.

A tampon should be easy now. Inserting the tampon successfully I instantly began to feel light-headed, dizzy, and actually felt like I was about to throw up. I would later learn I had what is referred to as a ‘vaso-vagal episode’. Symptoms often include feeling faint, clammy, nauseated, some people can even blackout.

This happens when the tampon touches or puts pressure on the cervix. For most people, touching the cervix isn’t an issue, if you have a ‘sensitive’ cervix then there is a chance you will experience a vaso-vaginal episode if the tampon touches your cervix.

At 22 I began experiencing painful sex with my then partner. A combination of not feeling comfortable, not being aroused, and feeling pressured into sex led to a diagnosis of secondary vaginismus.

For the next 12 months, I would struggle with penetrative sex. I began using dilators, attending physical therapy and seeing a sexual psychologist. Thankfully, I was able to overcome my vaginismus and once again enjoy pain-free sex.

I am now 27 years old, have been vaginismus-free for 4 years, and use a moon cup each month when I menstruate. I no longer compare myself to others, I don’t care what menstrual product someone else uses, nor would I ever judge someone for their choice. I realise menstruating is nothing to be ashamed of, nor is it the same experience for every person.

The market for menstruation has changed and adapted, there are now any number of options at the supermarket, drugstore, or online. For example, period underwear has emerged as a more sustainable option, along with moon cups and other devices.

I live in Australia, a country I wish would adopt free menstrual products for schools. A country that needs to do more to recognise pain such as endometriosis, vaginismus, and vulvodynia.

I still hate tampons.

I still carry a pad, just in case.

 

Leah T.

Leah is the founder of GINA app, and has overcome secondary vaginismus. 

Do you have a story you would like to share? Send an email to hello@ginaapp.com with the subject line ‘GINA Blog’ and we will get back to you. 

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GINA Blog: Dating and other kinds of torture

What’s worse? Discovering you’ve got a condition where your pelvic floor muscles contract involuntarily, making any kind of vaginal penetration difficult, or, dating with vaginismus?

They both suck tbh.

Dating can be stressful enough as it is. Outfits, date ideas, awkward conversation pauses, kissing, touching, COVID-19, food stuck in your teeth.

What happens if things go well? What happens if you’re feeling some feelings and are super attracted? How will you bring up talking about sex BEFORE you even HAVE sex?

What if they have never heard of vaginismus and you have to sit there and explain it all while trying not to ruin the ‘mood’.

Many people self-sabotage. That’s right. They sabotage it all before even getting to the bedroom for fear of rejection and humiliation (and pain). The most important thing to remember in this moment is that we are all worthy of pleasure.

We all deserve to experience pleasurable, pain-free, and safe, consensual sex. Difference should not equal shame. You are different, your pelvic floor works differently and your body responds differently to pain. You are still worthy of pleasure.

The first time you have to have the ‘vaginismus’ talk with a sexual partner will be the hardest. Each time after that will be a breeze. If you are met with a negative response the world will not end. Get yourself out of there and don’t waste any more of your time or energy (or cute outfits). They probably have a very cut and dry understanding of what ‘sex’ is. A lack of curiosity and creativity sounds like a bland time anyway.

If you are met with understanding and support (and feel comfortable) then go for it! There is so much more to sex than penetration, however, we’ve all been raised (brainwashed) into thinking there is one way to have ‘sex’.

It’s OK to feel self-conscious, anxious, and even a little scared of what will happen in the moment, but don’t let the fear hold you back from dating or casual sex.

Don’t deprive yourself of the weird, hilarious, awkward, magical, and disastrous world that is dating!

Plus dating isn’t the worst D word. Diarrhoea is.

 

Leah T. 

Leah is the founder of GINA app and dated lots when she had vaginismus. 

Do you have a story you would like to share? Send us an email at hello@ginaapp.com with the subject line ‘GINA Blog’ and we will get back to you. 

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Welcome

Resources

Abbott, J.A., Jarvis, S.K., Lyons, S.D., Thomson, A. and Vancaille, T.G. (2006). Botulinum Toxin Type A for Chronic Pain and Pelvic Floor Spasm in Women. Obstetrics & Gynecology, 108(4), pp.915–923. Available at https://doi.org/10.1097/01.aog.0000237100.29870.cc

Crowley, T., Goldmeier, D. and Hiller, J. (2009). Diagnosing and managing vaginismus. BMJ, 338(jun18 1), pp.b2284–b2284. Available at https://doi.org/10.1136/bmj.b2284

De Kruiff, M.E., Ter Kuile, M.M., Weijenborg, P.T.M. and van Larikveld, J.J.D.M. (2000). Vaginismus and dyspareunia: Is there a difference in clinical presentation? Journal of Psychosomatic Obstetrics & Gynecology, 21(3), pp.149–155. Available at https://doi.org/10.3109/01674820009075622

Goldstein, A.T., Pukall, C.F. and Goldstein, I. eds., (2009). Female Sexual Pain Disorders. Wiley. Available at https://onlinelibrary.wiley.com/doi/book/10.1002/9781444308136

KABAKÇI, E. and BATUR, S. (2003). Who Benefits from Cognitive Behavioral Therapy for Vaginismus? Journal of Sex & Marital Therapy, 29(4), pp.277–288. Available at https://doi.org/10.1080/00926230390195515

Lahaie, M.-A., Boyer, S.C., Amsel, R., Khalifé, S. and Binik, Y.M. (2010). Vaginismus: A Review of the Literature on the Classification/Diagnosis, Etiology and Treatment. Women’s Health, 6(5), pp.705–719. Available at https://doi.org/10.2217/WHE.10.46

Lamont, J.A. (1978). Vaginismus. American Journal of Obstetrics and Gynecology, 131(6), pp.632–636. Available at https://doi.org/10.1016/0002-9378(78)90822-0

Melnik T, Hawton K, McGuire H. (2012). Interventions for vaginismus. Cochrane Database of Systematic Reviews. Available at https://doi.org/10.1002/14651858.CD001760.pub2

Pacik, P.T. (2014). Understanding and treating vaginismus: a multimodal approach. International Urogynecology Journal, 25(12), pp.1613–1620. Available at https://doi.org/10.1007/s00192-014-2421-y

Pacik, P.T. (2009). Botox Treatment for Vaginismus. Plastic and Reconstructive Surgery, 124(6), pp.455. Available at https://doi.org/10.1097/prs.0b013e3181bf7f11

Reissing, E.D., Binik, Y.M., Khalif, S., Cohen, D. and Amsel, R. (2003). Etiological Correlates of Vaginismus: Sexual and Physical Abuse, Sexual Knowledge, Sexual Self-Schema, and Relationship Adjustment. Journal of Sex & Marital Therapy, 29(1), pp.47–59. Available at https://doi.org/10.1080/713847095

Reissing, E.D., Binik, Y.M., Khalifé, S., Cohen, D. and Amsel, R. (2004). Vaginal Spasm, Pain, and Behavior: An Empirical Investigation of the Diagnosis of Vaginismus. Archives of Sexual Behavior, 33(1), pp.5–17. Available at https://doi.org/10.1023/b:aseb.0000007458.32852.c8

Seyed, H. and Saadat (2014). Vaginismus: A Review of literature and Recent Updated Treatments. International Journal of Medical Reviews Review Article International Journal of Medical Reviews, pp.97–100. Available at http://www.ijmedrev.com/article_68899_2eacf2633ecf512c46c639eac6e2e015.pdf

ter Kuile, M.M., van Lankveld, J.J.D.M., Groot, E. de, Melles, R., Neffs, J. and Zandbergen, M. (2007). Cognitive-behavioral therapy for women with lifelong vaginismus: Process and prognostic factors. Behaviour Research and Therapy, 45(2), pp.359–373. Available at https://doi.org/10.1016/j.brat.2006.03.013

Watts, G. and Nettle, D. (2010). The Role of Anxiety in Vaginismus: A Case-Control Study. The Journal of Sexual Medicine, 7(1), pp.143–148. Available at https://doi.org/10.1111/j.1743-6109.2009.01365.x

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Ready, set, SEX!

Positions

Hopefully, by now we have well and truly established that sex is more than just penetration. If you are progressing with your dilators, it could be a good time to start experimenting with positions that allow for more control during penetrative sex. 

The goal here is to control the depth of penetration and move at a pace that makes you feel most comfortable. Below are some suggested positions you might like to try with a partner when you feel ready. 

But first, some important reminders: 

  • If these positions cause you any pain stop immediately, you don’t want to reinforce the pain fear loop 
  • Communicating with your partner is key, make sure to communicate at every step, this should be pain-free and enjoyable for you
  • Tweak these positions to suit you and your partner
  • You don’t need a partner with a penis, you can use fingers or toys 
  • Lube! Use lots and lots of lube (if you are using toys make sure to use the right kind – see our lube topic here)

On Top 

Positioning yourself on top of your partner allows you to have more control over the pace and depth of penetration. Start with your partner laying down flat on their back. Next, your partner should bend their knees and place their feet flat on the mattress. This position will allow you to climb on top (either facing away or towards your partner) and lean against their thighs for support. By leaning on your partner, you can concentrate more on relaxing your pelvic floor through deep belly breaths. Keep close attention to your inner thighs and try not to clench them. Instead transfer some of your weight onto your partner’s body and focus on relaxing your inner thigh muscles. 

Spooning

Spooning is a great position to limit clenching your thighs or pelvic floor muscles. Start by laying down on your side, then bring your knees up towards your tummy, almost as if you are crouching (or forming an S shape). Your partner should lay down next to you in a similar position. Your butt will act as a cushion here, and you can control the depth of penetration by sliding your legs down (into I shape) for deeper penetration. You can stay in an S shape or crouch to decrease the depth of penetration. Focus on your breathing and communicating with your partner. This position also allows for a clitoral reach-around from your partner or the opportunity for you to clitorally stimulate yourself, as this is a hands-free sex position.

‘Outercourse’ 

Tongues, toys, and touching! Oral sex, mutual masturbation, and ‘outercourse’ are great choices for enjoying sex without penetration. Focus on what brings you pleasure and release yourself from the pressure to have penetrative sex. 

Some studies have shown that only 18.4% of people with a vagina orgasm from penetrative sex alone

If you don’t find this type of sex enjoyable and you experience pain from touching outside around the vulva you could have vulvodynia, check out or glossary to learn how this is different from vaginismus.