Dr McEvoy on her research insights, compassionate practices & understanding Vaginismus as a sociocultural phenomenon

In this vaginismus series article, special guest and psychologist Dr Maria McEvoy kindly shares some insights and findings about her research into Vaginismus, what to consider when choosing therapies and interventions which have a positive impact, and the barriers preventing women from seeking help.

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Psychologist, Dr Maria McEvoy

When women come for sex therapy to discuss their Vaginismus, they have many unanswered questions and misconceptions about the problem. Shame, stigma, fear and embarrassment hold women back from seeking help. If this sounds like you, take a breath… it is not your fault.

This is a cultural problem. Sadly, because of the lack of open conversations about women’s sexual health in Ireland, or any topics about female sexuality and the vulva and vagina region, women are left feeling alone and confused about their bodies and how to move forward towards transformation.

Our Vaginismus expert shares the research insights which resonated with her as we open the conversation on this female sexual dysfunction shedding some light on the concerns raised by many women inside the therapy room.

In fact, it is from reading Maria’s deeply moving research about women’s experiences of vaginismus in Ireland that I decided to start this blog!

I hope that your inner thoughts and feelings are validated by her words if you experience any degree of vaginismus or sexual pain. There is hope, support, and specialists who can create a treatment plan with you in mind – and a new wave of focus in Ireland on female sexuality is happening.

Dr McEvoys research findings about Vaginismus express the silent and unheard voices and experiences of women and couples with the condition and those health professionals who help them, enhancing the understanding of vaginismus and the role of sensitivity in care. If you can, I suggest you take the time to read her research and the participant’s stories carefully and often shared narratives and find what resonates for you.

It is so important for all women, not only those with vaginismus, to feel empowered and safe in her sexuality – not repressed or burdened by sexual shame.

Empowerment grows! It can be achieved on different levels through raising awareness, expert quality information, sex re-education on aspects of biology, sexuality, the arousal template and pelvic health while also seeking the relevant help of experienced professionals.

Many of my clients express getting lost in the world of online forums and internet searches seeking answers prior to starting therapy – only to be left feeling increasingly overwhelmed and anxious. This is one of the reasons I created this vaginismus blog series, to raise awareness of holistic and integrative interventions and professional opinions on the subject.

About the research

Vaginismus in an Irish Context is based on the interviews of eighteen professionals who work with women and couples with Vaginismus and ten couples who had experienced or were currently experiencing the condition at the time of the study. It is available to download and read on the DCU website at ‘Vaginsmus in the Irish context: a grounded study, and you can also visit vaginismusresearchireland.com. It is the first research of its kind in Ireland and the latest research on vaginismus in Ireland since 1979!

I asked the wonderful and inspiring Dr McEvoy to answer some common questions and share with our readers what resonated deeply with her on hearing the women’s, partners and professional stories and experiences of Vaginismus;

The silent sense of shame

What impacted me most throughout this research was the deep shame that women experiencing Vaginismus felt. They frequently said that they did not feel like a proper woman, and they felt so confused that something which was so seemingly easy for everybody else was so difficult for them.

They felt like they were the only ones experiencing this difficulty because they had never heard of anyone else who had it and sometimes did not even have a word or words for their experience. 

They often had not told family or friends because they felt that they would be unable to understand. If they were in a relationship, they often felt very guilty for the condition’s impact on their partners. 

The turning points for women starting to resolve Vaginismus

There were several key turning points for women with the condition that my research identified talking with the women, these were;

A common condition: It was finding out how common Vaginismus is for Irish women, understanding that they were not alone in this experience and that it was a difficulty that could be resolved.

Psychological & Physical: Understanding that Vaginismus has a psychological as well as a physical component, and once treatment acknowledges the psychological (and psychosexual) aspect, the difficulty can begin to be resolved in both aspects.

A sociocultural Phenomenon: Understanding that when you consider your upbringing and culture’s role in shaping the person you become – that Vaginismus is a sociocultural phenomenon rather than a personal failing. It represents the protective response to a society or culture that does not support the autonomy and sexuality of women. These messages have an impact that manifests as a physical response, but these messages can be challenged. Women and couples can choose their own narrative and reclaim their sexuality.

Resolving Vaginismus with or without a partner

Some women who come to therapy in my practice have concerns and reservations about starting therapy because they are not in an intimate or committed relationship or fear that their partner may not engage fully in an emotionally supportive way.

Psychosexual therapy works with the client where she is in her life right now, working positively and reassuringly with the conditions and circumstances of each woman. As a therapist, I help women to understand that they can manage Vaginismus holistically on many levels with or without an intimate partner. Together we create a treatment plan that can be inclusive of partners or not. Ultimately their journey is a personal one of self-discovery, understanding what works for her treatment wise and developing fulfilling self-intimacy and acceptance.

Maria says, Vaginismus can be treated in the context of a couple or by the woman herself without a partner. Some women in relationships are more comfortable doing the therapy alone, and some want to include their partners; of course, some women are not currently in relationships.

Many therapists involved in the research said that Vaginismus typically does not recur once it has been resolved unless there is a particular reason, e.g. painful childbirth, but that the women and couples had learned skills that they could fall back on if this was to occur.

Some couples said they felt like what they had learned in overcoming Vaginismus were life skills they could use going forward in their relationship and made them stronger. Some learned to enjoy orgasm and fulfilling intimacy in other ways with vaginismus. They believed their relationship was even better because they had been through something of this magnitude and resolved it together.

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Therapies and interventions tailored to each woman

There is a range of therapies and treatment interventions for women with vaginismus. You can read more about these in the blog embracing a holistic and integrative path for resolving vaginismus.

Seeking the support and reassurance of an experienced therapist can have a direct positive and nurturing impact on outcomes for the woman. I asked Maria her thoughts on how women can choose therapies and interventions for themselves.  

Therapies have to be tailored toward the woman rather than imposing a one-size-fits-all linear model.

It is essential in any therapy and treatment that the woman decides what she feels comfortable with. Some therapies will include both physical and psychological components. Women can work with healthcare professionals to determine which aspects of the therapy are helpful and which are less helpful at that time.

The felt connection with the healthcare professional is the most crucial factor in all cases. Some women find that working with a specialist pelvic physiotherapist provides support, and others less so. For some, talking therapies such as psychosexual therapy is the most effective, unpacking all of the sociocultural messages and family dynamics that might have contributed to the development of Vaginismus.

A common barrier which may prevent women from seeking intervention sooner is a perception or fear that health professionals will insist on an intimate examination to confirm the diagnosis. This can cause further trauma and should not be insisted upon.

If the experience of Vaginismus resonates with women, otherwise called a self-diagnosis, they should be believed. Therapy should not be based on a linear one-size-fits-all model but should be tailored toward the individual with elements of physical and psychological therapies where appropriate.

Vaginismus is not caused by sexual abuse. This myth is one of the most significant barriers to getting help, it is a persistent belief and misconception that can be found online, even suggested by some medical professionals. An experience of sexual abuse is not the case for the vast majority of women who experience Vaginismus. A fear that this will be suggested or assumed when they seek help prevents many women from doing so.

For some women, dilators are helpful, and for others, they cause anxiety. It is always crucial if using dilators and starting dilator training to have a health care professional provide guidance and advice; otherwise, they might end up causing further distress and trauma. You can read more about dilators in my blog, everything you need to know about choosing dilators for dilator training.

Also, for some, guided self-love exercises help to coach the woman in exploring their own bodies and mastering self-pleasure, but for some women with Vaginismus, looking at or touching their bodies can induce anxiety. If that is the case, this should not be insisted upon.

Understanding shame and reclaiming your sexuality

Because of the deep shame inherent in experiencing Vaginismus, the women are often very harsh in their judgment of themselves. When women learn about how common Vaginismus is and the contributing factors, they can begin to understand that this is not a personal failing; it is a healthy protective response to familial or sociocultural messages that not only is sex and female sexuality shameful but that they are shameful for having those feelings and wanting to have a sexual relationship.

Women who grow up in these restrictive circumstances frequently feel that they are not given a choice, they can have the love and approval of their families, or they can have a sexual relationship with their partners but not both.

In understanding how these messages impact from a very early age, women and couples can decide to take control of their own sexuality and make their own decisions about their bodies and their sexuality.

The process of overcoming Vaginismus positively impacts self-esteem, reclaiming control over your life and strengthening the relationship with yourself and your partner.

Listen to Dr Maria McEvoy talking about Vaginismus in these following Irish podcasts

The Glow West Podcast with Dr. Caroline West – Vaginismus and Healing (2022)

Private Education Podcast with Aislinn Keenan Episode #76 – Vaginismus, whats the cause and whats the cure with Dr McEvoy (2022)

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Orlagh Reid Psychotherapy

Orlagh Reid

Orlagh Reid is an IACP accredited Counsellor & Psychotherapist, Addiction Counsellor, Gottman Couples Therapist and Fertility Counsellor in private practice based in Co. Kildare, Ireland and worldwide online via DOXY. She specialises in addiction, recovery, well-being and clinical sexology. To find out more or to book an online consultation visit www.orlaghreid.ie

Orlagh Reid Psychotherapy MIACP Therapy Ireland

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