In this episode of What to Expect When You’re Injecting, host Cassie Silver speaks with Dr Chandrika Parmar, a gynecologist and fertility specialist at Genea Fertility Melbourne City. The topic? Vaginismus, a condition that remains largely undiscussed but deeply affects many women, particularly in their journey toward conception.
Understanding Vaginismus: What Is It Really?
Vaginismus is more than just discomfort during intimacy. It is defined by involuntary muscle spasms of the vaginal walls, often triggered by attempts at penetration be it a tampon, a pap smear, or intercourse. These spasms are not in the woman’s control and can be incredibly distressing.
According to Dr. Parmar, many women don’t even know the name of the condition they’ve been struggling with. They suffer in silence, mistakenly believing they are alone or abnormal. Vaginismus may be primary (present from first sexual experiences) or secondary (arising later due to trauma, childbirth, or menopause).
It’s More Common Than You Think
Statistically, vaginismus affects about 0.5% to 1% of the population, but those numbers likely underestimate the reality due to underreporting. In clinical settings, the number jumps to 5–15% among patients seeking help. The emotional burden often deters people from seeking treatment, perpetuating the silence and shame.
Symptoms and Red Flags
If you’re wondering whether you might be experiencing vaginismus, common signs include:
- Inability to insert tampons or menstrual cups
- Painful or impossible gynecological exams
- Inability to engage in sexual intercourse
- Feelings of hitting a ‘wall’ during penetration
- Extreme anxiety or fear around intimacy
A Compassionate Approach to Diagnosis
Dr. Parmar emphasizes that her clinic does not perform immediate physical examinations. Instead, she builds a rapport with patients first. For diagnosis, trans-abdominal scans (rather than trans-vaginal) are used initially, and treatments are only introduced when patients feel safe and ready.
Why Talking About It Matters
The cultural silence around vaginismus adds to the emotional toll. “Nobody should be uncomfortable. Period,” says Dr. Parmar. Discussing it openly helps normalize the condition and encourages others to seek support.
The Treatment Journey: Multi-Disciplinary Care
Effective treatment of vaginismus typically involves a combination of:
- Gynecological assessment to rule out physical abnormalities.
- Pelvic floor physiotherapy, including biofeedback and the use of vaginal dilators.
- Psychological therapy, preferably with professionals trained in sexual health.
Patients motivated to work through all three aspects often see success within 6–12 months.
The Role of Partners and Support Systems
Support from a partner or loved one can be instrumental. Some women even bring sisters or close friends to appointments. Communication, patience, and mutual understanding can transform treatment into a journey of healing and intimacy.
What About Fertility?
One major concern with vaginismus is the impact on fertility. Penetrative intercourse can be painful or impossible, but that doesn’t mean parenthood is out of reach. Genea Fertility offers:
- Self-insemination under medical guidance
- IUI and IVF with general anesthesia
- Tailored treatment plans that prioritize both fertility and emotional well-being
No Need to Wait
Dr. Parmar encourages patients over 35 or those with known issues not to delay treatment. Like other infertility diagnoses, vaginismus can qualify for early intervention, bypassing traditional wait periods.
The Psychological and Physical Connection
True recovery involves both mind and body. Emotional trauma, including past sexual abuse, can significantly affect progress. Hence, integrated care is key.
Debunking Myths and Misconceptions
Dr. Parmar highlights several myths:
- Vaginismus is not just in your head.
- It’s not caused by a partner’s size.
- It can be managed, even cured with the right support.
Childbirth and Vaginismus
Postpartum anatomical changes or traumatic deliveries can trigger secondary vaginismus. Similarly, some women may opt for C-sections due to ongoing discomfort, though vaginal birth is possible with proper preparation.
Practical First Steps
If you suspect vaginismus, start by asking yourself:
- Is sex painful?
- Can I insert a tampon comfortably?
- Do I avoid gynecological exams due to fear or pain?
Your first stop should be a GP, followed by a specialist like Dr. Parmar.
A Holistic Model of Care
Genea Fertility’s model includes collaborative care with gynecologists, psychologists, and physiotherapists, ensuring comprehensive support. From pain management to fertility treatment, the focus is on patient-centered, judgment-free care.
Resources to Explore
- Sexual Health Australia
- Jean Hailes for Women’s Health
- Pelvic Pain Foundation of Australia
- Patient-led Facebook support groups
- Vulva and vaginal pain associations
Final Thoughts
“There is help. You should not suffer in silence,” Dr. Parmar concludes. Whether it’s for better intimacy or the dream of starting a family, healing begins with a conversation.
Listen to the episode here
