Pleasure and pain: Why we need to demystify women’s sexual dysfunction

Why do we know so little about women's sexual dysfunction?

Why do we know so little about women's sexual dysfunction? Photo: Getty

Want longer lasting loving? Most Australians recall a time when bright red and yellow billboards and late-night TV commercials dominated our roads and screens – but few have even heard of vaginismus.

In recent years, these large-scale campaigns have targeted men’s sexual dysfunction and health, starting conversations and seeking to end the stigma.

But when it comes to women’s sexual dysfunction, most of us remain in the dark.

One in three women will experience pain during sex, while up to 17 per cent (that’s one in 10 women), will be diagnosed with a related condition called vaginismus.

With so many women facing these daunting, painful experiences, why are their journeys through treatment still defined by isolation and embarrassment?

And if roughly one in 10 women are battling this condition, why does it remain a relative mystery?

Silent pain

Vaginismus is a condition where the muscles around the vagina involuntarily contract, causing pain and discomfort during penetration.

The condition can arise following sexual trauma, childbirth, menopause, or, in many cases, spontaneously.

No cure is known, but treatment is available, though it is often expensive and extremely difficult to access.

Leah Angela is the creator of the world’s first vaginismus app called GINA, which went live on app stores this week.

Ms Angela was diagnosed with vaginismus three years ago when she was 24.

She felt let down and disappointed with the lack of knowledge and support provided by the medical system.

“I was sexually active for a number of years and enjoyed a healthy sex life, but then I started experiencing pain during sex with my partner at the time,” Ms Angela told The New Daily.

“I didn’t think much of it, and I tried to push through thinking that it was just a couple of isolated incidents, but months later when I was finally diagnosed, the doctor just handed me a factsheet and I was left to research the rest on my own.”

Ms Angela’s experience is typical, with sufferers of vaginismus facing months or years worth of tests, misdiagnosis and frequently have their symptoms dismissed by medical practitioners.

“There’s shame and taboo associated with women and sex – society views sex for women as reproduction, not as pleasure and enjoyment.”

Gabrielle Jackson, journalist and author of Pain and Prejudice, agreed with this sentiment, saying the sexism in our medical system is insidious.

“Women haven’t been told that sexual wellbeing is a part of our health … yet we know a third of women have regularly painful penetrative sex,” Jackson told The New Daily.

Studies also show that women from conservative backgrounds where female pleasure is not prioritised, and women’s sexual pain is normalised, face a higher risk of developing vaginismus.

“In cultures where sex isn’t talked about, girls and women don’t even know that they’re supposed to feel pleasure.”

Muted by the medical system

The number of women suffering from vaginismus is thought to be significantly higher than the current estimate of up to 17 per cent.

This is because, culturally, women’s sexual health is considered by the medical system to be inextricably linked to reproduction.

“Doctors, researchers and policymakers have all been men, and that’s how they view sex – something that men need and that women ‘give’ to them,” Jackson said.

Unlike male-based conditions like erectile dysfunction or premature ejaculation, very little funding has been contributed to exploring women’s sexual health outside of reproduction.

“A woeful lack of research has ever been done on it, and we’re fighting centuries of stigmatisation at the same time,” she said.

“Almost all animal studies are done, predominantly, on male animals, and women still only make up 30 per cent of participants in clinical trials.

“And almost everything we know about human health has come from the study of male humans and male animals. That’s why we don’t know much about this, because it hasn’t been studied.”

For Ms Angela, the mystery and confusion she encountered in the medical system was reflected in online communities, where other sufferers seemed just as lost as she was.

“The amount of research that exists is so limited it’s a joke, and it’s so old that GPs are telling women to just have a glass of wine and relax and you’ll be fine,” she said.

“Half the research articles are written by men, the literature is so narrow and the communities online are extremely narrow too.”

People with vaginismus also suffer from a pain-fear loop, where their symptoms worsen based on the anticipation of pain.

Following outdated advice can have the reverse effect and may significantly aggravate symptoms.

Hope in sight

The lack of research and the shame associated with female sexual dysfunction conditions means that sufferers can feel isolated and powerless.

In addition, many face cultural and socioeconomic barriers that further limit them when considering treatment.

Throughout her own journey, Ms Angela felt she had been betrayed by her body, and by those tasked with helping her.

“When I was comfortable to start dating again, it really impacted the way I expressed myself sexually,” she said.

“I was a confident and flirtatious person and I almost felt that I couldn’t be that way because I didn’t want to let people down in some way.”

This led her to develop GINA, an app that gives people with vaginismus honest, realistic advice and holds their hand down the (often lonely) road of sexual dysfunction.

The concept is groundbreaking, Jackson said, and could be the friendly push people need to seek treatment.

“Having reliable information would be amazing, and just to be able to talk openly with people who have had the same experience as you can be life-changing,” she said.

“Once you realise you’re not alone, it can be easier finding a health professional who can help you.

“To just go in there having never talked to anyone else about it can be quite overwhelming – the act of destigmatisation can be a really powerful thing.”

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