Fear of sex: Vaginismus 

This article explores vaginismus, including what it is, its causes and how hypnotherapy and CBT can help you have more pleasurable, pain-free intercourse. 

What is vaginismus?

Vaginismus is a condition where the muscles of a woman’s vagina spasms or tightens before penetration of a tampon, finger, vaginal dilator or penis. This is mostly a psychosexual problem caused by fear and anxiety. This is not to say that the condition is not physical or the pain is not real. Fear and anxiety cause the involuntary spasms of the muscles which in turn causes pain, burning or discomfort.

Causes of vaginismus 

Most cases of vaginismus are psychological. There can also be a physical reason in a smaller number of cases and so it’s best to get a check-up with a doctor. Psychological causes may include:

• a fear that your vagina isn’t large enough for penetration
• beliefs about sex being dirty or shameful
• a difficult medical examination
• sexual and physical abuse
• traumatic childbirth

Shame and guilt

Last year, I met a woman socially who wanted to know about my hypnobirthing course in great detail, even though she was not pregnant. At a subsequent meeting, she told me that she was petrified of conceiving and giving birth as she suffered from vaginismus. She was desperate to have a child and her vaginismus was coming in the way of her relationship and happiness. It caused her constant anxiety along with feelings of guilt and shame.

Another woman, in her early 30s, opened up about her fear of never being able to enjoy sex or find a partner. She told me that men she dated would run as soon as they realised that she was not able to have sex. She felt embarrassed, frustrated, sad and isolated. She had no idea where to seek help as the doctor had ruled out any physical condition.

Mind-body connection

One of the first things that I demonstrate to clients when we start working together on most issues is the mind-body connection. Our thoughts have a direct impact on our bodies. If you have any doubt about this, take a few seconds and think about your favourite snack for a moment, be it a piece of lush chocolate cake or a bag of salt and vinegar crisps. Does your mouth salivate? Mine is salivating just writing this. Now imagine standing on the ledge of a skyscraper - do you notice your muscles tighten up? These are easy and obvious examples of the mind-body connection. Our body reacts in a similar way to most of our thoughts, but because we are so caught up in the moment, we are unable to notice these reactions.

How can CBT and hypnotherapy help? 

Vaginismus can be seen as a ‘vicious cycle’ of thoughts where:

• A woman anticipates pain upon penetration.
• This causes an involuntary contraction in her vaginal muscles.
• The tightening of the muscles creates resistance and pain upon penetration if it is achieved.
• The initial fear of pain is reinforced.
• The woman avoids intimacy and the fear builds up.

Using CBT tools, a therapist can help you break this vicious cycle. You can change your mind and body’s conditioned response to penetration. Hypnotherapy can primarily help you with deep relaxation at a mental and muscular level. A trained hypnotherapist can teach you skills to relax on command and also learn to be in the moment using mindfulness techniques. Other techniques like graded exposure and systematic desensitisation that combine CBT and hypnotherapy, help you face your fear in a gradual way in a safe and relaxed environment.

A hypnotherapist will also be able to help you replace your negative mental associations about the size of your vagina, penetration or sex with positive and more helpful thoughts. You can learn how to relax your vaginal muscles and experience pleasurable, pain-free intercourse.