- Maybe you've never heard of vaginismus before.
Maybe you never learned about it in a sex ed in school,
but suddenly in your adult years.
The word is just cropping up everywhere.
Maybe you have it.
Maybe your partner has it.
Maybe you did learn about it in sex ed.
I didn't know vaginismus existed until I was in my twenties.
And a couple of friends of mine opened up to me
about their experiences with it.
Before then, I honestly had no idea
and I was listening to them like,
wait, your vagina doesn't what?
And it has a name, so let's get into it.
But before we do,
hello, my name is Hannah.
I make videos about sex and relationships.
And if you wanna see more of that kind of content,
then please do subscribe if you'd like to.
We're gonna be saying a lot of vulgar words in this video,
vaginismus, vagina, vaginal
and you're just gonna have to get used to it.
What is vaginismus?
Vaginismus is the involuntary contraction
of vaginal muscles,
making penetration difficult, painful, or impossible.
It might be something you've always experienced,
or you may have previously been able to enjoy
painless penetrative vaginal sex.
These are some common symptoms of vaginismus,
difficult or impossible vaginal penetration,
a stinging or burning pain during sex,
difficulty inserting things like tampons
or menstrual cups and difficulty having a pelvic exam
with a speculum like a cervical screening
and we will get onto that later.
Vaginismus can take many different forms.
Maybe you can't insert artificial objects
like tampons and speculums and dildols,
but you are able to insert body parts
like fingers and penises.
Maybe you can have penetration when you're having solo sex,
but you can't when having partner sex
or maybe you just can't insert anything at all
under any circumstance.
A really important thing to note is that the contractions
are involuntary and they can happen
even if you are super aroused
and being enjoying other kinds of external sexual activity.
But then when it comes to vaginal penetration,
your vagina's just like, no.
It can lead to people feeling broken
or that the vagina doesn't work
or that they're doing something wrong.
It's not just a physically painful condition,
but it can be really emotionally frustrating and upsetting,
but it is very common.
Around 27,000 people in the UK have vaginismus.
And that number may be more because people feel ashamed
to go to their doctor about it.
If you have vaginismus, you are not broken.
It is not your fault.
There is absolutely nothing to be ashamed of
and it can be treated.
There are other things that can cause pain
during vaginal penetration,
such as, but not limited to STIs, thrush, endometriosis.
I am not a medical professional and neither is Google.
So, please do go to your doctor for a proper diagnosis.
What causes vaginismus?
I don't know about you,
but vaginismus was never spoken about in sex education,
but what was given several mentions in the classroom,
but then also on the playground
was that if you have a vagina,
the first time you have penetrative sex
and times after that it will hurt.
This can have lots of implications
believing that vaginal penetration will hurt
receiving a sex negative education
with no emphasis on pleasure
can be a cause of vaginismus.
If you do find a vaginal penetration painful or impossible
and because we were taught it's supposed to hurt
and we weren't taught about vaginismus.
You may not realise that you have vaginismus
and that you can get help.
And then also,
even if you don't have vaginismus,
you may occasionally experience discomfort during sex.
And again, we were taught it's supposed to hurt
and we weren't taught
things about healthy communication, pleasure.
We might think that that discomfort is normal
and that we have to put up with it.
And we don't know how to communicate with our partner
about that because we've not been given
the tools to do that.
We also might not feel comfortable asking to use lube,
which is amazing and totally normal.
Anyway, I'm so mad about the it's gonna hurt education.
I'm so mad about it, so mad.
Back to vaginismus, there are potential physical
and psychological causes of vaginismus.
For each individual with vaginismus it'll be different.
It might be one thing, or it might be a cocktail of things
all interacting with each other.
Physical causes might be medical thrush,
endometriosis, certain medications,
the list is very long, so, do speak to your doctor.
Childbirth or miscarriage,
menopausal changes, pelvic trauma,
such as surgery or examinations
and physical or sexual abuse or rape.
Psychological causes, it could be fear
and anxiety or stress.
This could be fair that your vagina is too small.
Fear of tearing, fear of unintended pregnancy
or STIs, performance anxiety, guilt,
or negative experiences towards sex
or bad sexual experiences.
The list is endless.
There are so many anxieties that we have about sex.
Issues with your partner, maybe there's abuse, distrust,
fear of being vulnerable or lack of communication,
previous sexual or emotional trauma
and childhood, hehe childhood,
this could be sex negative or inadequate sex education,
a strict religious upbringing
that held a lot of negative values around sex.
Believing sex is shameful or wrong.
And just a general shame and silence
around sexuality topics.
That is a lot of stuff.
And sometimes there might not be an explainable cause.
And it's not always useful splitting things up
into physical causes or psychological causes
because often they can't be separated
and one can impact the other.
Let's talk about Pelvic Exams.
There are different reasons why you might need
a pelvic exam,
but a common one is for a cervical screening.
In the UK from the age of 25,
if you are someone with a cervix,
then every few years, you need to get a cervical screening.
This is really important to attend
because it's one of the best ways
to protect yourself from cervical cancer.
It's not a test for cancer
it's to help prevent it,
by checking the cells for HPV.
At the ripe old age of 28,
I have now had two cervical screenings.
A cervical screening is carried out
by a medical professional and it involves a speculum
being inserted into the vagina
and a soft brush being used to take a sample of cells
from the cervix.
However, if you have vaginismus or cervical screening
or any kind of pelvic exam
can be really challenging.
So, here is Dr. Anita Mitra,
AKA the Gynae Geek with some tips.
- Hannah, thank you so much for inviting me
to be on your YouTube channel.
I would just like to let you all know
that this is a gynaecologist approved YouTube channel
because I recommend it to my patients all the time.
So hello, if any of you are watching.
So, my job in obstetrics and gynaecology involves
doing speculum examinations all the time.
I'll be completely honest.
I don't really like having them done to me.
So, I completely understand
that you guys may also not really enjoy it.
And for a lot of people,
it is quite frankly traumatic.
And so my job is to try and make you feel
as comfortable as possible.
And I will take this to an extreme
because I want sing happy birthday with someone
while she had her smear test done.
So, it's really important that you do let us know
so you can tell us as much or as little
about why you don't like it,
but you really don't have to disclose anything
that you don't feel comfortable to.
But just if we know,
then there are a lot of things that we can do.
So, first things first,
you don't have to have me singing to you.
You can bring your own music,
so you could bring your phone
and put it on the desk, that's absolutely fine.
And you can also bring somebody with you
who you think will be able to help you
feel more comfortable throughout.
And also just to let you know,
there's normally a member of nursing staff there
who is that help the person who's taking the test,
but also just to be able to talk to you,
hold your hand,
whatever you want, it's not a problem.
Just let us know.
Now, you can also ask for a double appointment
because it's important that you don't feel rushed.
You're never wasting anyone's time.
And even if you don't manage to have the tests done
and you need to come back another day,
if I've helped you feel a little bit more able
to have it done again, then that's fine.
That's not a waste of time. We've achieved something,
but a double appointment can be a way of just meaning
that there is a little bit more time
and you might feel a little bit more at ease.
Now, we take the test on a couch.
And normally what we do is we ask you
to lie in this kind of frog leg position.
So, you bend your knees and bring your feet
as close to bottom as you can,
you keep your feet and your ankles together
and then let your knees flop apart.
This helps us because it means
it brings the cervix forward.
So, helps with visualisation during the examination.
But also it helps you because if your legs are flopped down
and completely relaxed,
which I acknowledged is difficult to do,
but the more relaxed your legs are,
then it means that the muscles around the vagina,
the pelvic floor can also be more relaxed and helps us
to do the examination more quickly and efficiently.
Now, the other thing is that no one likes the word speculum.
So, I'm going to show you one briefly.
This is the speculum, okay.
Now, this is the bit that goes inside
and this is the handle that we use to open it.
And this little thing here is a little nut
that we use to hold it open.
Now, we don't always need to crank it all the way
all to stimulate, open it as much as I need to.
Now, the insertion is often the bit that people
find really uncomfortable and really difficult,
particularly if you have vaginismus.
So, some people find that inserting the speculum themselves
is helpful and I'm more than happy
for you to do this and I can help and guide as well.
And you can also ask for us to do it as slowly as you need.
And we can talk you through the whole experience.
Now, in terms of lubricant,
we're not supposed to put lubricant on the tips
if we're doing a smear test,
because if you get lube all over the cervix,
then that ruins the test unfortunately,
but I, along with many other people
will often put a bit of lube around this part here
so that it's not going to smear all over the cervix,
but it just means that the insertion is a little bit easier.
Now, the thing that we don't use is anaesthetic cream.
So, that's a numbing cream and we don't use it
because it just numbs the skin.
And so if it's uncomfortable
because of the fact that the muscles are tight,
then that isn't going to be helpful.
Now, as I said before, if you need to come back,
not a problem, you're not wasting anyone's time.
We just really want you to feel comfortable
and not under pressure.
The other thing is that I often discuss with patients
about seeking help in terms of talking therapy.
So, seeing a psychologist or a psychotherapist,
somebody who's going to be able to talk through
and make a bit of progress more for the long-term.
And now these things can take time,
but it can be a useful investment
in terms of being able to look after your health
in the future.
So, good luck and just speak to us, let us know.
There are lots of things that we can do,
and I hope that you found this helpful.
- Thank you so much, Dr. Mitra,
also if you yourself are a medical professional,
the vaginismus network who are a community
of people with vaginismus,
created a guide for how to make your patients
with vaginismus feel more comfortable
during pelvic examinations.
And I will link that in the description.
How to treat vaginismus.
Depending on your cocktail of things that might be causing
your vaginismus treatment will be different for everyone.
But, before we get into specific treatments,
I need you to know that you do not have to have vaginal sex.
Is more important to have pleasurable sex
and the kind of sex you enjoy
rather than the kind of sex
that you think you should be having.
In our assess heteronormative society,
sex has become synonymous with penis in vagina sex.
But sex and pleasure is so much more than that.
We often feel this pressure to have a penis in vagina sex,
because it's what counts as real sex.
It's going all the way.
And we demote every other sexual act to foreplay
rather than an equally appealing dish on the sex menu.
We love a good sex food analogy.
Not everyone is into penis in vagina sex
and not every sexual encounter involves somebody
with a penis and somebody with a vagina
sex is multifaceted.
And I just wanna put it out there
that you can have an amazing pleasurable satisfying sex life
without vaginal penetration, shock horror.
Just take it from Lily and Ola
in season two of sex education,
but equally absolutely no shame.
If vaginal penetration is something that you want,
if you previously found it really enjoyable and pleasurable,
or if the idea of it is really hot and turns you on,
or if you and your partner are trying for a baby
and want to be able to have penis in vagina sex,
there are some treatments available.
The different treatments are all about retraining the body
and retraining the mind.
So, here are some potential treatments.
Therapy, talking through any past trauma
that you may have fears, anxieties,
shame and guilt around sex,
potential body image issues, relationship issues.
You might be encouraged or taught
to do relaxation techniques, such as mindfulness,
breathing exercises or sensate focus,
pelvic floor exercises, those key goals.
She's doing them now.
Cause she thinks about it and she's doing them.
This can help you gain control over those muscles
that keep contracting.
The NHS has a pelvic floor exercises app
and it can send you notification reminders
and guide you through doing your reps.
And there are also vaginal trainers.
They come in sets like this.
So, they're all different sizes.
This is the baby one.
And you can start with this and work your way up.
I would recommend getting professional advice
on the best way to use these.
You don't necessarily have to use actual dilators like this.
You can use your fingers,
like start with one and then
maybe move up to two, three, et cetera.
This specific set were gifted to me by Lovehoney.
However, dilators are available on the NHS,
but it can vary from place to place how accessible they are.
So, if vaginal dilators
is something that you wanted to try
and your doctor recommends,
definitely ask them about where you can get access to some.
Another thing that I will mention
is that Shush Women's Store have a donation scheme,
so you can effectively pay it forward
with somebody on low income,
because a full set is actually really expensive,
but through Shush website, you can donate five pounds,
you can donate 10 pounds, 15,
like whatever you want to donate.
And that will go towards a fund that allows people
to access free sets if they can't afford one.
So, I will link all of the info to that stuff
in the description.
And also in general and this is for everybody,
not just people with vaginismus,
but it's really important to take your time.
Being a relaxed state of mind and mentally present
for sexual activity really helps with arousal
and do not force penetration.
If it's not going in, even after lots of lube,
it's not going in and forcing it can cause more pain
and potential injury.
And please never use numbing creams,
numbing gels to treat vaginismus.
These don't actually relax the muscles
that are contracting
and you won't be able to feel if penetration
is causing injury.
Thank you so much for watching
and thank you to Dr. Anita Mitra
for taking part in this video,
I will leave a link in the description to her Instagram,
the Gynae Geek, which is an amazing resource
for all gynae related stuff.
There is also a whole section
on vaginismus on the hormone diaries website,
where people have submitted
their own stories and experiences.
I'm still going through submissions and posting them.
So, I'm sure there'll be more to come,
but you can have a read of people's experiences
with vaginismus and even share your own.
Thanks again for watching
and I'll see you in my next video, bye.