Why My Treatment for Vaginismus Changed Everything

Last year, singer and songwriter Meghan Trainor revealed that she had been diagnosed with vaginismus, a condition that causes pain and discomfort during penetrative sex. While exact numbers are hard to quantify (likely due to feelings of shame surrounding the condition), vaginismus is a common female sexual dysfunction.

And yet, our mainstream awareness of the condition and its treatment options are very limited.

Meghan Trainor dragged vaginismus out from under our beds, into the spotlight, and I salute her. I may not have the same platform, but I certainly have experience with treatment for the condition, and I wish I had easier access to this information before beginning my own treatment journey.

So, I'd like to lift the veil, open the door, put the feet in the stirrups, if you will, and offer some insight into the unique specialist treatment I received for vaginismus while living in the Netherlands.

The path that ultimately led to my successful treatment started like many of ours do, with a diagnosis from a gynaecologist. "There's nothing wrong with you," my gynaecologist told me as she removed her gloves, "it's just unfortunate." I lifted my feet from the stirrups, visibly upset by what had just transpired in the gynaecological exam room of a hospital in Holland.

While her words may have come across as a bit harsh, my gynaecologist was actually very empathetic towards me. She offered me some tissues, sat me down at her desk in an adjoining room, and gently explained to me that I have a condition called vaginismus.

She held up her hand in a tight fist. "This is what your pelvic floor muscles are doing when I try to examine you." This rudimental demonstration laid the foundation for my understanding of vaginismus. However, a more professional definition would be that vaginismus is "a recurrent difficulty with vaginal penetration due to involuntary muscle spasms", as Rajal Patel, MD, a gynaecologist and vulvovaginal specialist at Northwestern Medicine Center For Sexual Medicine and Menopause, previously told PS UK.

These muscle spasms can cause you to experience sharp or burning pain when you attempt to penetrate the vagina, for example, during sex, while inserting a tampon, or trying to undergo a gynaecological exam. It often feels like there's a brick wall inside of you — turns out it's your surprisingly powerful pelvic floor muscles.

After some late-night-doom-Googling, I suspected that I had the condition, which is why I had asked my GP to refer me to my gynaecologist. What I didn't expect, however, was that my gynaecologist would then refer me to someone else.

She explained that there were experts based in Leiden, the city I lived in, who offered specialised treatment for the condition. There was a long waiting list, but she would put me on it. I was referred to the Outpatient Clinic for Psychosomatic Gynecology and Sexology at the Leiden University Medical Centre.

A mere 10-minute walk from my front door, I would later learn that the hospital was home to not one but two of only a handful of Europe's uniquely qualified specialists for treating vaginismus. According to my doctor, they had patients who travelled from as far afield as Africa to seek treatment.

The first step in my treatment was to have what the clinic called a "combination consultation." As part of this intake procedure, I would meet with both a gynaecologist in training and a specialist from the clinic. The gynaecological appointment was to establish whether there were any physical conditions (such as infection, scarring, ovarian cysts, or endometriosis) that could cause the pain I was experiencing during penetration.

However, I, like many women with vaginismus, experienced a lot of discomfort when my first pelvic floor exam was attempted. As a result, by the time this new gynaecologist walked down the polished hallway and called out my name, I was a snivelling mess — but she did something that surprised me.

Instead of awkwardly ushering me onto the chair and into the stirrups, she sat me down and informed me that it was important that I have a pelvic floor exam at some point in the near future, but I was clearly in no state to be examined this time around. So we walked through my medical history, and she explained that her evaluation would be passed on to my specialist.

While I felt disappointed that I, a grown woman, could work myself into such a state about a simple medical exam, I felt completely understood by my doctor. I learned that this particular clinic even allowed patients to take home plastic speculums so that they could practice and adjust to the penetration themselves.

Thankfully, the next step in the intake procedure didn't involve any speculums, but it would be intrusive in other ways. I was scheduled to sit with a sexologist.

According to the Outpatient Clinic for Psychosomatic Gynecology and Sexology website, the clinic is "recognised as a centre for expertise in Sexology."

However, going in, I didn't quite know what this meant. Was I supposed to just sit and talk? Would this magically open the nether-floodgates, so to say?

A few weeks later, I found myself sitting across from a doctor named Charlotte. Not only was Charlotte a sexologist, but also a gynaecologist and psychologist. I didn't know it yet, but she was going to be my saving grace — the many Thank You cards scattered around her office probably should have hinted at this.

She explained that the purpose of this meeting was to establish whether there had been any particular experiences in my past or aspects of my upbringing that could have contributed to my vaginismus.

Experts don't know of one specific cause for vaginismus. However, according to the Cleveland Clinic, a common trigger can be a "fear of sex or negative feelings about sex, perhaps due to past sexual abuse, rape or trauma."

We spoke about my upbringing, whether I had experienced any trauma, my sexual development, and my relationship at the time.

We both agreed that I hadn't experienced any sexual trauma. However, given my reaction to receiving a pelvic floor exam, and my description of previous sexual experiences, she did conclude something interesting: I had a phobia.

"Some people have a phobia of spiders, you have a phobia of penetration," she told me with a friendly smile. Did I think this sounded ridiculous? Yes. But did it also make complete sense? Yes. Fortunately, she had a treatment plan in mind for me.

As part of this treatment, both myself and my partner at the time were advised to take a week off work and attend three sessions at the hospital clinic. During these sessions, Charlotte would coach me as I penetrated myself. My partner was encouraged to sit in on these sessions in order to better understand the treatment and how he could be helpful.

Thankfully, he was very supportive and open to taking the time to do this (if he wanted to, he would ladies). There was a waiting list, but once we received our timeslot, we pulled ourselves out of work and headed to the hospital.

My first session lasted three hours, and once again, I was a blubbering mess. However, Charlotte assured me that my reaction was completely normal. "There will be tears," she told me, "but I want you to work through them."

And indeed, any progress I made was completely up to me. During these sessions, she explained that she wouldn't lay a single hand on me. I would be the one doing the penetrating, no one else.

The goal of these sessions was to rewire my association of penetration with pain. In order to do this, I would need to retrain my pelvic floor muscles not to tense up in anticipation of pain.

I would do this by slowly penetrating myself with smaller to larger objects. In my case, we found I reacted better if I used my own fingers, starting with one and adding more as I progressed.

As I inserted them, I was told to squeeze and relax my pelvic floor muscles. Each time the muscles relaxed, I was asked to take note of what I was experiencing. Was I feeling pain? Was it receding? And to my surprise, it was.

Charlotte was nothing short of amazing. She offered words of encouragement when I turned to despair, while also being firm enough to get me progressing through the various goals.

My partner and I attended three of these sessions over the course of the week. However, the treatment didn't stop once we walked out the hospital doors. In between these sessions, we also had homework. I was instructed to continue with the pelvic floor exercises at home, using my fingers as well as a set of silicone vaginal dilators.

Of course, with my ultimate goal being painless penetrative sex, we were also encouraged to hop into bed as much as we could. We were given pamphlets detailing the best positions for less painful intercourse, and we were encouraged to incorporate my pelvic floor exercises into our foreplay.

My doctor explained that the idea behind this treatment was that participants would start to see results within the first two weeks. My muscles needed to relearn, and that wasn't going to happen by taking small steps over a long period of time.

Once the first week was complete, I was excited to see that I actually could penetrate myself with my fingers without feeling pain — but it seemed I still had trouble allowing my partner to take control of the penetration.

However, this week was just the beginning. The next step was for myself and my partner to attend sexologist appointments with Charlotte.

In the months that followed, I attended regular sexologist appointments with Charlotte. Sometimes I came alone, other times with my partner. We discussed our progress at home, as well as our feelings towards my vaginismus and how this affected our relationship. It was through these sessions that I also came to the painful realisation that there were issues within our relationship that may have contributed to my being unable to physically open up.

It was an outcome of the treatment that I never expected. My ex and I weren't compatible in the way that we wanted, and we ultimately broke up before we could ever reach the goal post of pain-free penetration.

But this isn't a sob story. Two years down the line from my treatment, I can happily report that I can enjoy penetrative sex, and I owe that entirely to the help I received. However, I have a message for all my vaginismus girlies out there: if there's anything I learned from this unique experience, it's not just how to have pain-free penetration. It's also that penetrative sex isn't the be-all and end-all when it comes to having a healthy and enjoyable sex life.

Maybe you'll never experience penetration without pain, but that doesn't mean you can't have a fulfilling sex life. That being said, you shouldn't have to experience the pain you're feeling and you shouldn't feel ashamed in seeking out help. There are professionals and techniques out there that can help you overcome vaginismus. You've got this.

Sarah O'Leary is a senior editor for DutchReview, a leading English-language publication in the Netherlands. Her work has also been featured by Metro. Sarah's areas of expertise range from relationships to the unusual drug habits of historical Dutch figures. When she isn't acting as a safety threat to herself and others (cycling), you'll find her sipping coffee, writing or creating prints.