Another sharing experience on a case of Vaginismus

Assalamualaikum and good day Doctor.

My name is XX and I have been married for 7 months. At first week of marriage, I never allowed my husband to do penetration because I was so scared of sex since the people around me keep saying the first time is gonna be hurt. It was purely anxiety. But then, I thought I was ready and we tried, and unfortunately it was not just a myth. It really hurts.

Even after a month, we still didn’t manage to penetrate because I will always be in pain. Alhamdulillah being an allied health worker, I know how the vagina works and that there is something wrong with me so I need to find the solution ASAP. So I decided to search for the reason behind it. I came across vaginismus and I thought of going to a psychiatrist. However, the only sex therapist I found on internet was too far (since I live in southern, and the therapist mostly in central region) so I decided to make an appointment with an obgyn at a private hospital I work at.

During the appointment, the obgyn did a pelvic examination on me and she said that nothing is wrong with me. She managed to insert one whole finger in me, which my husband and I never did. She said to be more relaxed and gave us few tips on good positions to reduce pain. She also adviced us to try using fingers frequently to train the pelvic muscles. Despite my husband told her that he felt like hitting a wall, the obgyn never mentioned vaginismus to us, and diagnosed me as dyspareunia.

After the appointment, we tried all the tips the obgyn gave and yet we still didn’t succeed. Though I would say there was very little improvement because now after 6 months, I finally managed to insert a finger like the obgyn did without any pain although i still felt uncomfortable. I was ready and lubricated enough, yet penetration is never a success, still.

So I made another appointment with the obgyn, and again, she gave few more tips and she suggested to buy vaginal dilators. She didn’t opt for operation because according to her, I may be experienced more pain associated with the surgery. So I am thinking of buying the dilators and try again at least a month. And if things are going better, I guess I’ll be okay soon. But if not, I’m thinking of going to psychiatrist. Can you tell me the procedures of going to psychiatrist? Does government hospital offers this kind of therapy? Or do I have to search for private psychiatrist?

Thank you for your time, Doctor. Any response is highly appreciated. Million thanks.

Prof Dr Ramli Musa

Pakar Psikiatri  / Psychiatrist

Universiti Islam Antarabangsa Malaysia

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As salam,

To my analysis, your O&G specialist is treating you as a vaginismus case though he/she did not mention it explicitly. This is based on the use of exposure principle approach such as digital insertion and dilator.

Exposure or graded exposure is the way to go to overcome the fear or “phobia”

The exposure has to be done in gradual or graded.

In overseas, the successful rate of vaginismus is high.

So in short, it is treattable.

The key to success is STRONG DETERMINATION

May I share your anonymous experience in your 1st email as an input for public awareness?

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Sure, Dr. That was my intention when I first emailed you, please continue doing what you do and keep educating our people.

(Most of the answers to the questions are posted in my earlier posts or my published journal article)