[Jennifer Dembo, LCSW]

Hello Sarah 233 – thanks for your great question! I think the dialogue between you and recessivegenequeen is very important, and it illustrates just how unique every woman’s experience with vaginismus, their treatment and their approach to it is.

The most important thing we know about vaginismus diagnosis and treatment is that it MUST be customized for each and every woman. Someone might require more physical support with dilation, others need additional psycho/emotional guidance. And there is a wide spectrum all along the way.

Also, after re-reading your initial question – I’m curious as to whether you’re taking about a behavioral therapist or a pelvic floor physical therapist? The former – unless otherwise qualified to provide medical care – will not ever examine nor treat your physical body. A PFPT, on the other hand, often does internal work (with consent only, of course) as part of treatment.

Either way – all of this must be tailored to each patient, and everyone on the team should ideally be working in concert in order to provide collective support and effective treatment modalities that compliment one another. If for any reason you’re not getting what you need, please speak up and tell your providers! Most of us aren’t taught to self-advocate in a medical setting, but we MUST in order to secure the highest standard and most respectful of care.

[Jennifer Dembo, LCSW]

Hi littlebear – thanks so much for sharing your story with us!

It is so, so helpful for women who experience vaginismus to hear from others with similar challenges. It’s equally helpful for women to share solutions!

Everyone experiences the condition in their own way, and the same goes for treatment. For those who would like to have penetrative sex with a partner someday, the final challenge is intercourse (READERS: please note that everyone has their own objectives for treatment). And as you so well articulated, this part can be a real hurdle for those who are single.

You, littlebear, sought guidance and employed creativity to meet your goals. While the partner you had intercourse with isn’t someone with whom you’re romantically interested, you were both aware of the situation, you were both consenting adults, and it sounds like he was a supportive, patient and understanding sexual partner.
With a foundation of safety and consent, women with vaginismus should seek out creative ways in which to reach their goals, according to their unique needs and preferences.

Congrats, littlebear – we’re so happy to hear about your success!

[Jennifer Dembo, LCSW]

Hi lucyjay – thanks so much for posting.

How frustrating! Sounds like you were having all these great sexual experiences and then a painful one that had a strong impact on you physically and emotionally.

I hope you’re getting appropriate treatment and guidance RE: your vaginismus diagnosis. Additionally, I recommend that you learn more about the brain-vagina connection (what’s our strongest and most influential sex organ? The BRAIN!) so that you can re-engage with it on a positive level. This doesn’t happen overnight – it’s a process that takes practice. But with the right support – you’ll get there, in your own time. This is the concept of neuroplasticity.

If you don’t know where to start with either avenue of treatment, give us a call at Maze. We offer free 10-minute phone consults and can help you decide what might be next in regard to your healing process.

Be well and take care!

[Jennifer Dembo, LCSW]

Hi janice – thanks for writing and welcome to our community!

I’m sorry to hear about your experiences, but I assure you that you aren’t alone!

I also want to applaud your willingness to seek support, and your ability to advocate for yourself by getting a second opinion when the initial provider’s answer wasn’t sufficient for you.

The answer to your specific question depends upon each individual, their unique anatomy, etc. You may want to consider returning to a gyn for a consult to help you make the decision that is right for you.

If you are near our offices and would like to schedule an initial visit (or start with a 10-minute free consult) we are only too happy to diagnose and offer potential treatment options. I wish you all our best!

[Jennifer Dembo, LCSW]

Thanks so much for your encouragement and support of tammy’s, Heather! There is no greater source than someone who has shared a similar experience.

Good luck, tammyg and let us know if we can be of further help!

[Jennifer Dembo, LCSW]

Thank you so much for sharing your story, @isabelw! I’m sorry you had to struggle with intercourse early on and that you weren’t accurately diagnosed. Ultimately, I’m grateful you continued to advocate for yourself, that you were able to get appropriate support and that you are now successfully able to be sexually active according to what you want!

Your experience is – unfortunately – so illustrative of the serious inadequacies we continue to experience in women’s health. Why is medical training so incredibly far behind in this area? We hear stories like yours at Maze day in and day out – it never ceases to amaze me how common your experience is (wrong diagnosis, providers not understanding the anatomy and women’s sexuality in general, etc.) The only way we’re going to change the system is to keep talking and sharing and supporting one another, and demanding a higher standard of comprehensive, respective care.

Thanks again for writing to us and take care!

[Jennifer Dembo, LCSW]

Hi tammyg – thanks so much for writing and for your awesome question!

The answer is: everyone is different. Our bodies vary anatomically, neurologically, psychologically – you name it. So there is no way to corollate your vaginal muscles’ tolerance for penetration to how you process sensation there.

The only “normal” any woman should be concerned with is her own. Explore what works for you and what doesn’t, and if you experience any further challenges, seek out a midwife or gynecologist familiar with pelvic health concerns. Or give us a call! We offer free 10-minute phone consult and we can help you decide what your next steps might be.

[Jennifer Dembo, LCSW]

Hi lillyd,

I, too, am so sorry to hear about all that you’ve endured.

I agree with recessivegenequeen – your quest to uncover the genesis of your experience with vaginismus is totally understandable! And if you feel it will benefit to continue this exploration, then by all means, keep going (though it may not be something you’re ever able to fully uncover). But if you are ready for solid diagnosis and treatment (because vaginismus is very treatable!), then I encourage you to find the right provider who can guide you through the process.

If you are interested in learning more about our treatment plans at Maze, please check out the website and call us for a free 10-minute consult. Our distance dilation program is something we offer to those who can’t access our NY-based offices, and that might be of interest.

In any case – don’t ever stop exploring avenues for healing that meet your needs and preferences!

[Jennifer Dembo, LCSW]

Hi Charlotte25x,

Agree with all that recessivegenequeen and Melissa said above. I know the anxiety can really get stirred up with all that you’re experiencing. At Maze, we treat the whole experience of sexual pain, and that includes the emotional piece. If you’re not able to access our office for an appointment, I recommend you seek out counseling with someone who can help you manage the natural worry that arises, or at least maximize comfort/relaxation techniques you already rely on.

If you need more information, please don’t hesitate to reach out to us!

[Jennifer Dembo, LCSW]

Olive,

You’ve already heard from the amazing and very knowledgable women above, but I want to join in them acknowledging your story and celebrating your strength and resilience! Leave no stone unturned as you search for proper diagnosis and treatment and have faith you will. Don’t be deterred by ignorant care providers – the literature (and all the success stories of our own patients) proves vaginismus is a highly treatable condition.

Take your time and go at your own pace if you choose to go with dilators. Use lots of self-compassion, be patient with yourself and remember it’s about progression, not perfection. All best to you!

[Jennifer Dembo, LCSW]

Hi diercl48,

We all have these moments – minutes – days – weeks, etc. And the pandemic has done a lot to magnify our experiences both good and bad. I want to honor all of your incredible work and success and acknowledge the aggravatingly hard times, too.

Only you can decide what is best for you, so be true to yourself. I will say, however, that maintaining flexibility to whatever extent you can will serve you not only now, but in the future. And while we can’t predict what life will look like down the road, we at Maze do know that consistency is your best friend when it comes to dilation treatment. You can decide to stop at anytime – absolutely. Just know that you may have setbacks when it comes to the stretchiness of vaginal muscles if dilation isn’t maintained. Of course, it doesn’t mean you can’t return to treatment at some later on. We just like to promote the idea that knowledge is power, and want you to make a decision based on information.

No matter what road you choose – soak up the things that bring you joy, and appreciate all of your progress! Healing is never a straight line, and with careful consideration along the way, you’ll arrive wherever you need to be.

[Jennifer Dembo, LCSW]

Hi @emili23!

If you can be more specific, I’ll be able to answer your question. I’m not sure if you’re talking about working out in general, stretching (ie yoga, pilates, barre) or pelvic floor exercises. Happy to help – just let me know what particular info you’re seeking.

Thanks and looking forward to hearing from you!

[Jennifer Dembo, LCSW]

Hi @nigelsmum – welcome to our community! We’re so glad you found us and we thank you for sharing your story.

I’m so sorry to hear about your struggle with vaginismus. While vaginismus is rarely discussed (though it SHOULD be!), I can promise you that you aren’t alone, and we hear stories like yours all the time.

I’m relieved to know that your husband has been so patient and supportive, and I also want to acknowledge your concerns. Vaginismus affects many women interpersonally and this can be difficult to navigate.

Anxiety is almost always correlated with vaginismus, and while I know you’re looking forward to the Botox procedure, I do suggest you seek individual counseling to help you process your feelings and cultivate solid skills to help you cope. Additionally, it sounds like you and your husband could benefit from couples counseling (even if just a few sessions) so that you can continue this processing collectively with an experienced guide holding safe space for you. We provide these services at Maze so please let us know if we can be of help or refer you to providers in your area.

Wishing you all my best!

[Jennifer Dembo, LCSW]

Thank you for posting this very important question (and resolution) with us, @Ettina!

It’s critical that we advocate for ourselves, but we all know society historically hasn’t made that an easy ride for women. At Maze, we’re committed to changing the narrative within the healthcare system. And so we encourage taking charge of your health and well-being by being curious, inquisitive and making informed decisions.

@Ettina – you demonstrated and proved that knowledge is power! Thanks again for sharing your experience with us.

[Jennifer Dembo, LCSW]

Hi @kaitsmith – welcome to our community!

Sorry to hear that you’ve been struggling. While proper diagnosis is key to successful treatment of any kind of pelvic pain, the experience you’re describing certainly sounds like it could be vaginismus. It is a highly treatable condition, so that’s the good news!

Dilators come in a variety of materials and widths, every woman’s body is unique, and a dilation protocol is rarely universal. While some women are able to use dilation on their own without guidance, we strongly recommend you seek support in order to establish a program that is customized specifically for you and your needs.

Anti-anxiety medications can certainly be part of treatment, but there are also behavioral modifications to seriously consider for whole healing.

If you’re interested in learning more about how we can help, consider calling us to arrange a free 10-minute consult. We offer on-site care for those in the NY metro area and distance dilation programs for those who aren’t nearby.

Take good care and let us know if you have any other questions!

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