Vaginismus

Nabila and Riyad had a beautiful wedding at the end of winter, three days of holud, nikah and reception. Eight months later, they have still not been able to have intercourse. Every attempt brings pain and panic. Their families have started asking about grandchildren. Nabila is sure something is wrong with her body. A gynaecologist told her to relax.

An illustration drawn from common experience. The people are invented; the pattern is not.

Understanding vaginismus

Vaginismus (part of sexual pain-penetration disorder in ICD-11) is an involuntary tightening of the muscles around the vagina that makes penetration painful or impossible, even when a woman wants intercourse. Fear of pain, anxiety about sex, a strict or silent upbringing around sexuality, past painful experiences, or trauma can all play a part; sometimes a physical cause contributes, which is why a careful examination matters. It is common, and in Bangladesh it is rarely spoken about.

Signs and symptoms of vaginismus

• Pain or inability to have intercourse, despite wanting to
• Fear or panic in anticipation of sex
• Difficulty with, or fear of, gynaecological examinations
• Strain, blame or silence growing in the relationship

Treatment for vaginismus

Treatment is gentle and private, and helps many women. It usually combines psychosexual therapy, education about the body, gradual exercises with dilators, and pelvic floor physiotherapy, often working with a gynaecologist. Partners take part, gently. Everything is confidential.

What getting better can look like

Nabila and Riyad might have weeks of patient, step-by-step work, and then an evening where fear does not have the last word.

Common questions about vaginismus

Is vaginismus treatable?

Yes, many women improve with treatment. It usually combines psychosexual therapy, education about the body, gradual exercises with dilators and pelvic floor physiotherapy, often alongside a gynaecologist. Care is gentle, private and confidential, and partners take part, gently.

Does vaginismus mean something is wrong with my body?

Vaginismus is an involuntary tightening of the muscles around the vagina, so it is not a choice and not something willpower can switch off. Fear of pain, anxiety about sex, upbringing, past painful experiences or trauma can all play a part. Sometimes a physical cause contributes, which is why a careful examination matters.

When to see a psychiatrist

If pain or fear is making intimacy impossible, you are not alone, and treatment helps many women.

Care here is personal: built around your history, your health and what you want to change, and reviewed with you as it goes.

If you or someone else is in immediate danger, call 999 or go to the nearest hospital emergency department.

Sources

• World Health Organization, ICD-11, HA20 Sexual pain-penetration disorder