Welcome to the first edition of Unscrewing Ourselves, where we hope to normalise topics on sexual and reproductive health and wellness.
Perhaps one of the greatest gifts of female friendships (among many, many others) is the inimitable joys of “girl talk” and the glut of education you attain from your sexually erudite friends. Some of my fondest memories is living vicariously through their (mostly) misadventures, and never really learning from any of them. And as sisterhood evolves, so does the gentility of these conversations. And it was during one of these enlightening sessions that I first learnt about vaginismus, and how common it really is.
Vaginismus is arguably one of the most common female sexual disorders, characterised as a “recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina”. The famous Masters and Johnson (William Masters and Virginia Johnson, who pioneered research on human sexual response and dysfunctions, and went on to inspire the TV series, Masters of Sex) aptly called it a “physio-psychological syndrome affecting women’s freedom of sexual response.” Across the world, about 6.5-15% of women have been reported to have experienced various levels of pain in their nether regions.
On home turf, mainstream research and data on the condition have eluded us. In this “first-of-its-kind” survey conducted between 2006 and 2013 by Kochi-based Promodu’s Institute of Sexual and Marital Health Pvt Ltd, 96% of the surveyed women had vaginismus. More recently, a small observational study, conducted in 2016 by the Tertiary Care Centre in Ahmedabad, factored in responses from 153 fertile women and found the prevalence of Female Sexual Dysfunction (desire, arousal, lubrication, orgasm, satisfaction and pain) among 55.5% of the cases.
The biggest concern, however, for us is the common thread that runs through sexual pain disorders: Psychological distress.
For many women who talk about it, there’s an openness (albeit hushed) about the guilt, shame and even a drastic impact on self-confidence, that comes with vaginismus—often more severe than the physical manifestations. To understand the lived experience of the condition, VICE spoke to Shalini Bhatnagar*, a 25-year-old Mumbai-based professional, who opens up about living—and dealing—with the pain of vaginismus:
"I found out about my vaginismus when I first had sex in 2014. I was 21. Being the anxious person that I am, I remember having over-researched the topic and developing quite a lot of anxiety for the actual event. I was very aware that the first time would be painful and I was bracing myself for it, rather than looking forward to enjoying the experience. In hindsight, that was a BIG MISTAKE. When the time came, I was so tense that I ruined the experience for both of us. My boyfriend was extremely supportive, though. But no matter how gentle and reassuring he was, I could not relax or allow penetration properly, resulting in a lot of pain during sex and even after.
It's not just physical pain and discomfort though; there's also a hell lot of burning due to friction between the tensed-up muscles and the condom. It's like someone has thrust a huge syringe in my vagina. It hurts and burns. The burning can continue even a day or two after sex. More than that, though, it affected my confidence—when I wasn’t aware of this condition, it affected me terribly. With no remedy in sight, I actually started believing that I am flawed and that this will last a lifetime. I just felt utterly hopeless.
The emotional trauma of vaginismus is far worse that the physical one, for both partners:
1. When you apprehend pain and discomfort before the act itself, there's no way you're going to experience pleasure yourself or be able to give it to your partner.
2. You feel an insurmountable level of guilt and shame for not being able to satisfy your partner.
3. You begin to shame yourself for being a “prude”.
4. You fear that your partner will abandon you because, let's face it, no one will want to stay in a relationship where the physical intimacy is THIS uncomfortable, unsatisfying and mentally harrowing. Even if your partner is extremely considerate, there's only so much sacrifice you can ask of him. And then, it’s only a matter of time when tough decisions will need to be made.
5. You will tend to fake pleasure and there's nothing worse than that.
6. You will start fearing pregnancy also.
Over the years, I have lived with the pain, alone. I am an extroverted introvert . So I’ve never really discussed this with my regular group of friends. But I’ve not hesitated in discussing this with my close girlfriends with whom I share a really solid bond. I feel that there are many women out there who are dealing with this cruel condition and are not even aware that it’s a recognised medical condition in the first place. There definitely needs to be more discussion on this topic. Since it's related to sex, which itself is a very stigmatised topic in our country, maybe that is the reason it’s not being discussed enough. I feel that women need to discuss this first with their gynaecologists (and please make sure she's a good one) before anyone else.
My diagnosis of vaginismus was accidental. I visited my gynaecologist in 2017 for a checkup for PCOS. When she mentioned conducting an internal examination, it sent shivers down my spine. She asked me to relax. I just couldn't. Ultimately, she gave up and asked me to get an ultrasound done. She then asked me if this tensing up occurs even during sex or if it was just was a one-off occasion. I gathered up the courage and finally opened up to her about the whole situation.
My gynaecologist’s solution was very clear: Have regular sex. I was in a long-distance relationship back then, and when I told her so, she immediately jotted down a number and gave it to me—to my utter bewilderment, it was the number of a dildo dealer in Mumbai! Yep. There are legit dealers out there who work with gynaecologists to supply dildos. I laughed so hard. I thought she was joking! When I didn’t see a change in her expression, it struck me that she was actually serious. Okay then.
Having a trustworthy gynaec/sexologist gave me the courage to not just open up, but also engage with healthy sex and practices without hesitation. You need to find ‘the one’ who’s open to listening to you without any judgement. I love my gynaecologist—she's excellent at giving advice and discussing sex the way it should be. We even had a good laugh at the end of my counselling session. A word of advice: If your gynaecologist asks you whether you're married or not when you mention sex, just get up and leave. It’s only going to go downhill from there.
Of course, your partner’s contribution is important too, for them to acknowledge and empathise. It will help if he/she is present at the time of counselling. Time, patience and regular practice are the essence of healing here. You and your partner need to explore options which can ease the pain, and take things slowly with patience. The latter cannot be emphasised enough.
Finally, did I go ahead with my dildo search? Well, Mumbai is not the ideal city to experiment with a sex toy because more often than not, you're sharing your accommodation with roommates (cue in a protest against its spiralling rents). However, I'm looking forward to my experiments with a vibrator, thanks to one of my girlfriends!"
You can learn more about vaginismus, healing, and treatment here .
If there’s a subject within the spectrum of sexual and reproductive health in India that you feel strongly about and want to vocalise it, write to firstname.lastname@example.org.
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