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“When I was in my late teens, I wanted to try tampons, but the thought itself made me clench.” — Revati
“I realized, masturbation wasn't possible for me and it hurt terribly. At that moment, I had just graduated from high school and didn't feel comfortable enough to talk about this difficulty or impossibility with anyone - be it a family member or a doctor.” — Divya Dureja
Revati is happily married and has a young daughter. Divya is a psychologist, a slam poet and a queer activist.
They are only two among many other women — each with a different story to share about personal discoveries, struggles and most importantly — acceptance.
Dr Mukta Kapila, Director, Obstetrics and Gynecology, Fortis Gurugram, explains the condition.
It becomes difficult for any sort of penetration to take place — intercourse, gynecological exam or even inserting a tampon. The realization, naturally, only strikes when such an attempt is being made.
There are two broad types: primary and secondary. In the former, the person has never been able to experience vaginal penetration, while in the latter, penetration had been possible before, but for reasons that could range from past trauma to some gynecologic surgery, it cannot be achieved now.
Through Divya’s and Revati’s experiences, we try and understand what the condition means to them, the emotional impact, and what they expect out of those around them.
“I had irregular menstrual cycles but the thought of getting an internal exam scared me away, so I couldn't even get myself to go see a gynecologist about it. I self-diagnosed myself with vaginismus, googling my symptoms. This was later confirmed by my obstetrician-gynecologist when we were trying to conceive.” - Revati
“Before I had my first intimate romantic relationship in 2010, I had never masturbated or seen porn. He helped me learn about my body and explore it. But I soon realized that masturbation isn’t possible for me.” - Divya
A few years later, Divya realized ‘something felt amiss’ — not because of her inability to have conventional sex, but because she didn’t want to be with men. And with women, the situation is different, she said.
“I knew that wasn't the case, but I didn't possess an alternative way to voice my concern, so I let that be.”
Divya knew something was wrong, but didn’t know what it was. Just like Revati, she discovered her condition herself, which was later confirmed by doctors. Around three years ago, she came across an article where a woman had described the pain she felt during penetration — “I feel like a wall is blocking the entrance to my vagina. And I feel a shooting unbearable fiery pain when any penetration is attempted.”
Divya knew what it felt like. And she now knew she could be having the same condition as this woman — Vaginismus.
To her, the diagnosis was liberating enough. She didn’t seek solutions. “I could feel and give pleasure and consummate the act of love in my own way.”
What follows after the diagnosis? For Divya, it was relief and liberation. But for Revati, it was different. “I just assumed that someday it would happen for me.”
Divya’s experience was different because the ‘performance anxiety and the feeling of not being able to satisfy your partner’, is more or less absent when she engages sexually with a woman. However, her active role in the India Vaginismus Support Community online and her access to Global Vaginismus Support Community have proven to her these feelings are common.
In a conversation with FIT, Dr Mukta Kapila brings up the importance of a supportive partner. She asserts that patience, consideration, responsibility and gentleness are all expected out of the partner, and an understanding person could help mitigate the psychological consequences in a woman to a great extent.
Revati, out of her own experience, agreed. “Patience and trust along with unending support go a long way in overcoming the issue. It did so in our case.”
Dr Deepa Dureja, Obstetrician and Gynaecologist from Delhi, and Divya’s mother, explains that vaginismus cannot always be put into exclusive categories. In fact, she points that while it is assumed that a past experience or some instilled fear or anxiety causes a woman to get diagnosed with the condition, it is actually also the other way round. The psychological problems may be the result of the pain and inability.
Another gynaecologist, Dr. Jayati Dureja, traces the research into this condition. “Vaginismus used to be a diagnosis of exclusion, when none of the other problems could be seen. A lot of research was done into the causes of vaginismus, and it came to be associated with a psycho-social-behavioral component. More recent research has shown that the increased tone of the perineal muscles is a major cause.”
In physical problems such as a tight hymen or muscle hypertonicity, dilators and special exercises need to be recommended.
Dr Deepa Dureja also discusses the effectiveness of cold laser therapy, that she has seen to be working in some of her patients, with extremely fast results. She calls for more research in the area.
“The discourse around penal-vaginal penetration distresses anyone who is unable to perform well in that area — be it a male with erectile dysfunction, a woman with vaginismus, vulvodynia, endometriosis or simply finds the act futile. How one views their inability and resolves it is the differentiating factor here.” - Divya
She goes on to say that pleasure and orgasm is important, but what we call ‘love making’ is entirely subjective and unique.
Women can experience pleasure in different ways. Clitoral stimulation, anal penetration, or stimulation in their labia minora. “The key to figuring this out is honest and open communication.”
Most importantly, it is important for a woman to know and understand pain. Divya explains, “To know what form of pain is okay and not okay is the key. Our primal instincts of assessing pain do kick in, but sadly, the society has told females to ‘endure’ pain during sex.” It’s time this is redefined.
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Published: 21 Aug 2019,04:07 PM IST