When the Gate is Shut–A Faithful Response to Vaginismus

Image Shutterstock

Image Shutterstock

Aleteia posted a deeply heartfelt article about a Catholic woman’s struggle with vaginismus, a disorder in which the muscles of the vagina involuntarily spasm or become rigid which makes intercourse either painful or, in extreme cases, impossible.

I don’t know anything about the author of the blog referenced in the article, except to say that, having read her posts, I can say that  she is a tremendously brave and honest woman who has, with her devoted husband, found ways to allow God’s grace and love to create something beautiful even in the midst of their profound suffering.  I find their courage through adversity to be inspiring and I am grateful for her and her husband’s witness.

How Common Is It?

I wish to be upfront that I am not writing this article as a response to her particular situation. As I say, I know nothing about her circumstances and I don’t presume to be able to offer answers that would address her particular concerns. I invite you to join me in praying that she and her husband will find the grace to continue their struggle in faith and, ultimately, find the healing they seek.

I do, however, want to chime in on the conversation because the issue is both not uncommon (occurring in about 2 of 1000 women in the general population and up to 5% of women who struggle with anxiety or depression) and tremendously sensitive.  For Catholic women, in particular, it can be difficult to find treatment options that are both effective and faithful.  Many Catholic women who suffer from this problem never seek professional help out of either embarrassment or concern that they will be asked to engage in treatment approaches that are inconsistent with their moral values.

Why Does It Happen?

The most common causes are sexual trauma, postpartum trauma, or poor sexual formation, but it can also be caused by issues related to OCD/scrupulosity, alexithymia (a difficulty with identifying or expressing emption), poor interoception (a kind of conscious alienation from one’s bodily senses), avoidant attachment (which can make physical affection of any kind feel overwhelming and intrusive), or other factors.

Can It Be Treated?

Research suggests that self-help approaches to vaginismus (involving self-help reading and dilation/relaxation exercises and other approaches found on the internet) have about a 10% success rate for treating this condition.  With proper treatment, research finds that over 95% of women can experience a full recovery from their symptoms.    For the remaining small percentage of women for whom standard treatment approaches are ineffective, virtually all can be successfully treated through a course of counseling, physical therapy, and the therapeutic use of Botox by a plastic surgeon.  In sum, the recovery rate for vaginismus is virtually 100% once the appropriate course of treatment has been identified.

What is the Process?

There is no cookie cutter approach to treating vaginismus, but effective treatment tends to follow 8 basic steps.

  1. A proper medical evaluation (gynecological/urological) to rule our potential medical/structural problems.
  2. A proper psychological history and review of the various psychological and physical therapy interventions.
  3. Evaluation/Education regarding the nature of sexual pain anatomy.
  4. Mindfulness based approaches to help the client gain conscious control over the automatic spasmodic vaginal response.
  5. Couple-based techniques designed to eliminate phobic responses to (non-sexual) physical intimacy
  6. Communication exercises that prepare the couple for full sexual intimacy
  7. Sexual counseling that help the couple find the least painful positions for successful intercourse
  8. Sexual communication exercises that help the couple overcome any remaining pain and experience the restoration of a fully satisfying sexual relationship.

Because no two women are the same, there are many variations these 8 steps can take.  It is because of the varied nature of treatment that self-help approaches often fail to produce the desired results.  For Catholic women, it can be important to work with a faithful professional who can help them apply these 8 steps in a manner that is respectful of their moral values.

Finding Faithful Help

The Catholic Psychotherapy Association can be a useful place to turn for local assistance in dealing with this sensitive issue.  For those who struggle to find a local provider, or for whom local resources are not adequate for one reason or another, Karin Roach, MSW, LISW-S, a Pastoral Counselor who specializes in women’s issues through the Pastoral Solutions Institute’s Catholic Tele-Counseling Practice can help guide clients down the path to healing.  For more information on living the fullness of the Catholic vision of love, check out Holy Sex!  The Catholic Guide to Toe-Curling, Mind-Blowing, Infallible Loving.


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