In Living with Vaginismus: Dealing with the World’s Most Painful Pleasure, Victoria Johnston provides a comprehensive overview of this pelvic pain condition. She opens up about her own personal experience in order to try to raise awareness about an issue that most people either don’t know about and/or aren’t comfortable talking about.
Vaginismus involves the involuntary contraction of pelvic muscles (the pubococcygeus or PC muscles) making it difficult or even impossible to penetrate the vagina with even small objects like a tampon. It refers specifically to the muscle contractions, and doesn’t encompass other sexual difficulties related to things like desire or ability to orgasm. One physiotherapist cited in the book describes vaginismus as panic attacks of the vagina, and Victoria describes sex as feeling “like you are being ripped apart”.
Unfortunately, even many medical practitioners have a poor understanding of vaginismus, and the book includes multiple stories of negative experiences with health care providers. The causes of vaginismus can be complex and multifactorial, and the book describes various physical and psychological factors that have been identified. The book also includes stories about the often devastating effects the disorder can have, including strain on relationships and problems with mental health.
Victoria describes the various treatments that are available, taking a holistic view and explaining that what’s most effective can vary greatly from person to person. Treatments include the use of dilators slowly progressing in size, physiotherapy, counselling, and medication. There is a chapter devoted to physiotherapy exercises, complete with photos to demonstrate. Another chapter describes Botox, a promising approach that isn’t yet commonly performed and is quite expensive.
The book includes contributions from a number of other women who live with pelvic pain. Many felt invalidated by their health care providers, and a common theme running through their stories was how alone they felt in their experience. The book also includes the stories of men whose partners have vaginismus. I was surprised by how many partner stories Victoria was able to gather, and how openly these men spoke. It really illustrated how this disorder isn’t just an individual problem; it’s an issue that couples need to face together.
Victoria calls out the many unreasonable societal expectations around sex, including the idea that is the only way of truly achieving closeness and connection, and the expectation that it’s normal for females to have pain during sex. She advocates for more realistic, open conversations about sex, something I heartily agree with.
While vaginismus manifests itself physically, mental health is often involved, either as a contributing factor or as a consequence. As such, it’s important to raise awareness in the realm of mental health as well as sexual health, which is why I thought it was important to review this book on my blog. I would definitely recommend it.
You can find Victoria on her blog Girl with the Paw Print Tattoo.
You can find my other book reviews here.
My first book, Psych Meds Made Simple: How & Why They Do What They Do, is available on Amazon as an ebook or paperback.