When I first had vaginismus symptoms, I wasn't aware of what the hell was going on. Getting an actual diagnosis, even though it took a long time, has been a game changer because it means I can arm myself with information. And I bloody love learning about stuff. Educating myself on this thing means I'm able to understand the what, why and how behind Vaginismus and that is pretty empowering. It has taken me from a place where I felt hopeless to feeling more positive about treatment and about life. But lets be real. I didn't just get there on my own. I saw a therapist a couple of years ago to help me process all of this. Strongly recommend. One of the things that she introduced me to was the fear/pain cycle which explains the psychological process behind Vaginismus and it makes a whole lot of sense. Before we get into this, I am not in any way a healthcare professional and you should seek help from medical/psychological assistance from the professionals rather than casual bloggers. In the meantime, I'll outline my understanding of it, from my perspective. So pain is really cool. Stay with me. Its something that your brain creates in order to protect your body from something that might hurt it. It's like a warning signal. Much like red flags when you date someone. It's also really subjective. Something that I might rate as 8/10 on a scale, you might rate as 4/10. There's no reliable universal way of measuring pain objectively. The normal way that we experience pain is in response to something like touching a hot pan. Your brain interprets the hot pan as a dangerous situation and it uses pain signals to tell your body to pull your hand away, in order to protect itself from further damage. Wonderful. Our brains are all-powerful and pain is helpful. Unfortunately, sometimes our wires get crossed and we feel pain in response and out of proportion to the actual situation. ENTER VAGINISMUS STAGE LEFT. My therapist explained the process behind the pain associated with Vaginismus as the Fear/Pain Cycle, which I've outlined below:
Anticipate: Your brain thinks you are in danger and so it sounds the alarm (this could be many things but lets say you are extremely nervous about having sex and are anticipating it being a horrible experience)
Brace: To protect you from the 'threat', i.e. the horrible experience, your body has an involuntary reaction and the vaginal muscles tighten to brace against it
Pain: The tight muscles make sex impossible and/or very painful
Reinforcement: The painful experience reinforces the original belief that there was real danger
Retention: Your brain therefore braces for pain on an on-going basis when faced with the same situation again
Avoidance: This may lead to avoidance of sexual intimacy, there may also be a lack of desire (check, check)
And so my friends, the circle (or list) is complete. ABPRRA. Catchy.
I think its important to understand this cycle because the treatments for Vaginismus are based around it. When I first tried dilators I really didn't understand what I was meant to be achieving, or why I was using dilators, and so I didn't have much success. The combination of dilation along with psychotherapy is aimed at breaking this fear/pain cycle which is easier said than done. The goal is to reduce the anxiety/fear of penetration which in turn reduces the involuntary tightening. We (my anxious vagina and I) are still very much working on breaking this cycle but are happily headed in the right direction. This Ted Ed video is a good 5 minute introduction to how pain works (not specific to Vaginismus) This website has some quite in depth info but I think this is actually a business? So, just FYI. It might not be strictly objective if they are selling stuff..
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