Vaginismus is when the vagina tightens up just as you try to insert something into it. It is the body's automatic reaction to the fear of some or all types of vaginal penetration. It can mean that using tampons is impossible and penetrative sex is out of the question. It can be painful and traumatic and embarrassing. Vaginismus can be treated – with physiotherapy and with psychosexual therapy – and some people will find that, after treatment, they can begin to insert things into their vaginas; that they can begin to have penetrative sex. Some women will decide that they are happy without treatment; that they can use pads or period pants instead of tampons or menstrual cups; that they can have a fulfilling sex life without penetration.
Shelby Hadden was a teenager when she realised that she had vaginismus. More than 10 years on, she has made a 10-minute film, Tightly Wound, about her experience of living with the condition.
The Pool chatted to Hadden – about pelvic-floor physiotherapy, attitudes to women’s pain and how she began to have penetrative sex in her twenties.
The Pool: Let’s start at the beginning. Could you just talk me through your problem and when you discovered it?
Shelby Hadden: When I was 14, I got my period – and I realised that I could not use a tampon. And I knew something was wrong. It felt like was no space in there, it was so painful, it just didn’t feel right. It took a lot of doctors and trying a lot of treatments that were wrong and weird… And finally I came across pelvic floor physical therapy – so I didn’t find the physical therapist until I was 21. And I was in physical therapy on and off for about four years, it took three months to be able to use a tampon, then eventually I was able to reach all my goals.
TP: When did you first go to a doctor? What age were you?
SH: I was 16.
TP: And what treatments were you offered?
SH: I was told to drink alcohol when I wanted to be intimate with someone – and that was before I was even the legal age to do so, not to mention, you know, encouraging a young girl to do that. And then I was told to use candles because the smallest dilator was about size of a tampon, so they were like “Why don’t you use candles?” and try inserting those. Then another doctor said to insert them when I was on my period because that way it would be lubricated. I had a doctor one time who refused to examine me because I wasn’t sexually active.
TP: So, what was their reasoning?
SH: I think she just didn’t want to waste her time, even though I was stressed out about this and concerned about it and wanted to be able to use a tampon, because I’m an active person and wearing pads when you do half marathons is really not fun! She didn’t even think it was worth looking at me.
TP: Why do you think doctors aren’t really equipped to deal with this? I think it’s not just your individual experience – I think lots of women with this diagnosis would say the same.
SH: I think that it comes from a long history of dismissing women’s pain and it’s easier to tell us that we’re hysterical and it’s all in our heads. They don’t have the answer and I think a lot of doctors feel pressure to come up with an answer even if they don’t really have one, so they give bad advice, so that they can say that they know what they’re doing.
I met someone and I think I was just really in a good place with physical therapy. I knew that the size dilator was a penis-sized one, so physically I thought I could probably do it
TP: There is often a psychological element to this condition – is that fair to say?
SH: Yeah, absolutely, so, if you’re expecting a lot of pain you’re going to tense up, and the muscles are going to spasm because your body is in stress, and then you’re scared of the pain, and you’re more scared, and it’s one big cycle.
TP: And were you referred to a psychologist, psychiatrist or therapist, as well as a physical therapist?
SH: Yes, I definitely needed a therapist throughout it.
TP: So you talked through this problem in therapy?
TP: And do you think that has worked in conjunction with the physical therapy? Do you think that was useful?
SH: Yeah, absolutely, I think that therapy is useful, and I think it’s just really important to have that support, especially because I didn’t have a partner and physical therapy is really time-consuming and uncomfortable and painful. It takes so long to see progress, or at least it did for me, and it was a really lonely and frustrating experience at times, so it was really great to have someone to talk through that with. And I had a lot of anxieties about sex and dating and dealing with an issue that people don’t know about or talk about.
TP: And when we talk about physical therapy, what was that like? It’s quite an intimate situation to go through, especially if you haven’t had intercourse and suddenly you’re going through this situation with a medical profession.
SH: Yeah, it’s a really intimate thing! She would start out doing external, deep-tissue massages – thighs and external muscles. Then she would work internally. Every physical therapist I’ve ever worked with has been so kind and experienced a lot – it was less uncomfortable and awkward than it could be. They were really well trained in that. My main physical therapist who I saw for two years – I was very close to her, and when I stopped going to physical therapy, it was kind of difficult. I had this person who I saw once a week, who was like my support system – it was a very weird experience to stop seeing her.
TP: And, at the end of the film, you reveal that you’ve fallen in love and had sex – penetrative sex?
TP: How did you make that breakthrough – was it something that came about at the end of these two years? How did that work?
SH: Yeah, it was toward the end of the two years. I was on vacation in South Korea and I met someone and I think I was just really in a good place with physical therapy. I knew that the size dilator was a penis-sized one, so physically I thought I could probably do it. And then, being on vacation and not having the pressure of ever seeing this person again… I was like, well, if it doesn’t go well he’s on the opposite side of the world! And I think all that in combination worked together to have it happen for the first time.
TP: Do you feel “cured” now or is this something you will have to consider for the rest of your life?
SH: For the most part, I’d say I’m cured; I don’t have to go to physical therapy any more. I keep up with my exercises at home, and I avoid doing things like crunches and sit-ups, so that I don’t regress, but there are some days, like, probably once a year, when I cannot use a tampon. And I don’t know why, but it’s just not happening, so you know, some days it’s harder than others, but for the most part, I’m totally fine, it doesn’t affect me much.
TP: So, why did you decide to make this film? What did you hope to achieve?
SH: I was at a really hopeless point; I was feeling like I was going to PT all the time, working so hard and not making the progress I wanted. I kept having really bad dating experiences, so I was just really angry. I felt so hopeless. And I decided, well, I’m a filmmaker anyway, why not create something out of this – be productive, take control of the narrative at least? I can’t really control if someone will be patient enough and I can’t control how quickly my body changes, but I can control what I do with my experiences. I couldn’t find any stories, any stories like mine, so I thought, if there’s nobody else making a story like this, I guess I’ll be that person.
TP: And what would you say to your 15-year-old self? Because obviously that was a tough time for you – milestones of teenagehood were not available to you.
SH: I guess I would say: "It’s all going to be OK. It’s going to take a lot longer, you’re going to feel way behind all of your friends and people your age, but that’s OK, because everyone has a different timeline and some things are worth the wait."
TP: And what do you want people to know about vaginismus?
SH: I want them to know that there’s treatment, that it’s not a death sentence on your sex life and that there are lots of people who want to help you reach all your goals. It takes a lot of time and hard work, but you can get there.