Hi there! Thanks for joining in for Episode 7, Season 1, of The Sensate Space podcast. In this episode we cover the most common sexual pain myths and bad advice for vaginismus / GPPPD and other sexual pain and pelvic pain conditions. Content warning: This episode discusses genito-pelvic pain.
You can listen in here or using the player below.
In this episode, we’re covering the top pieces of misguided advice often given to those who experience genito-pelvic pain like GPPPD / vaginismus. This is a good episode for people with this condition, as well as professionals or loved ones caring for someone with condition. I am to provide accurate information, reduce stigma, and help you understand why these misconceptions can be harmful.
Honestly, I had to take a bit of a step back when planning this episode. Thinking about all the experiences that I’ve heard from people with sexual pain disorders - it’s so frustrating and shows a real lack of understanding. So that’s the why behind this podcast episode - to get better information out there and reduce some of the stigma.
Anecdotally, I would say it’s the rule rather than the exception that people with genito-pelvic pain are given some terrible advice - whether it be from well-meaning family members or loved ones, or from professionals who aren’t as familiar with the condition as they should be.
There are some common themes that seem to be reported by people with lived experience - which keep coming up again and again and again.
So firstly - Why is bad advice, bad?
Of course, bad advice can be really frustrating. But the issue runs deeper.
Bad advice can be a real barrier to people seeking professional help and getting effective treatment - particularly if they think that it’s a problem with themselves, not the advice, that is stalling their progress.
When subpar advice falls short, it can make patients feel at fault - even though the advice was unlikely to help anyway. They are less likely to be open to trying other options, and more likely to experience self-blame and self-criticism. It can worsen feelings of shame, and cause people to question whether they might be unknowingly contributing to their condition (this is where spiritual and/or cultural beliefs can impact, too - just something to keep in mind).
Moreover, poor advice can deter individuals from openly sharing their experiences, or leave them feeling misunderstood or feeling like they’re not being taken seriously. This can also begin to impact relationships, even if the advice-giver is meaning well but misunderstands the condition.
Actually, giving bad advice can be a form of gaslighting. It usually comes across as invalidating - e.g. just try this one thing and you’ll be fine, or - it’s all in your head just relax about it. This can lead people to think that they’re just not trying hard enough or wanting it enough.
So, to sum it up, poor advice goes beyond causing frustration; it can create real roadblocks for those managing genito-pelvic pain conditions. We can’t keep thinking of it as ‘harmless advice’ with the risks we’ve just discussed.
So, with this in mind, let’s go through the top 5 pieces of bad advice most commonly given to this community. You can think of these 5 points as red flags - not necessarily against the person, but more so an indication that they might not have as much understanding or expertise in assessing and treating for this condition as you might need.
1. "Just relax"
The first piece of bad advice is being told to “Just relax.”
Telling someone with genito-pelvic pain disorder or vaginismus to "just relax" is so common. Variations of this can include being told to just “have a glass of wine” or have a bath first. Honestly, being told to “just” relax carries the same vibes as being told to ‘calm down’ when you’re angry - it kinda backfires. Similarly, it’s a bit like telling someone with depression to be happy, or with disordered eating to eat normally. It’s an outcome, not a strategy.
Being told to “just relax” is unhelpful because it oversimplifies a complex medical condition. This disorder is typically characterised by involuntary muscle spasms and tension in the pelvic floor, making it nearly impossible for individuals to relax at will (although this is a skill that can be learned with physiotherapy!). As I’ve said, such advice can inadvertently add pressure and guilt, implying that the condition is solely due to the person's stress or anxiety, when in reality, it is a multifaceted medical issue that requires understanding and specialised treatment.
2. "It's supposed to hurt... keep trying"
The next piece of bad advice is the idea that “It’s supposed to hurt,” or push through the pain and just keep practising.
From a very young age, female-presenting people are exposed to this idea that it’s normal for sex to hurt (so - for example, think of all the coming-of-age teen movies talking about painful first times). Similarly, uterus-owners are often dismissed when reporting pelvic pain such as endometriosis flares. We don’t speak enough about the fact that pain isn’t normal, and it isn’t something we should expect to live with.
This idea of “just push through the pain” is dangerous and counterproductive.
In vaginismus, there's a phenomenon known as the pain-anxiety cycle. Here's how it works: when individuals with vaginismus expect pain during sexual activity due to their past experiences, they naturally become anxious and tense. This heightened anxiety causes their pelvic floor muscles to involuntarily contract, making penetration even more painful or impossible, which in turn confirms their fear of pain. (The key word here is involuntary - think about how you blink when something comes near your eye. Same thing). This creates a cycle where pain and anxiety feed into each other, making it increasingly difficult to relax and engage in pain-free intimacy. So this means that every time someone “pushes through” painful sex, it’s reinforcing the idea in their mind that sex is dangerous to them, and subconsciously their body could try to protect themselves from it happening again by reinforcing the barrier and really, making the problem worse. And of course - this isn’t even beginning to address the psychological risk of continuing through pain which is a whole episode on itself!
3. P*rn/erotica
Moving on, the next piece of advice is p*rn/erotica.
This is based on the idea that sexual pain is due to low arousal. We know that this isn’t the case for GPPPD, and although some people may find it a helpful part of their treatment (no judgement here), it’s not the quick fix that people may think it is. Again, this approach oversimplifies a complex medical condition. This disorder is predominantly characterised by involuntary muscle spasms and tension in the pelvic floor, which isn’t a low arousal issue - although it may result in low arousal.
4. Kegels and vaginismus
Next, we have the crowd favourite advice of kegels.
There seems to be this misconception out there that all pelvic floor issues can be fixed with kegels. Not true! They’re not the be all and end all, and in the case of hypertonic or hyper-tense pelvic floors, it might actually make the condition worse. This is exactly why we recommend an individualised assessment from a physiotherapist who specialises in pelvic floor issues.
5. Lubricant
Finally, the last piece of advice - Lubricant.
“Have you tried lubricant?”. You can probably guess what I’m going to say here… again, this is oversimplifying a complex medical problem. It might be useful or part of treatment for some people, but it’s not a quick fix for this condition because it doesn’t address the pelvic floor muscles and spasms, nor does it address the pain-anxiety cycle.
Unfortunately, there aren’t really any quick fixes. But - that doesn’t mean that treatment isn’t possible. Invest your time into treatment pathways that are evidence based instead. Linking with an experienced professional like a gynaecologist or pelvic floor physiotherapist
Summary
In this episode, we've highlighted the harm caused by common misconceptions and bad advice regarding genito-pelvic pain. We've explored how these misguided notions can hinder progress and perpetuate stigma. Remember, there's hope for treatment and understanding, but it begins with accurate information.
If you or someone you know is experiencing genito-pelvic pain, seek support from a healthcare professional who specialises in this condition. Education and empathy are key to breaking the cycle of misinformation. And don’t forget to check out our website thesensatespace.com for free pelvic pain resources.
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This is a psychology podcast about vaginismus and other pelvic and sexual pain disorders, and related issues (genito-pelvic pain/penetration disorder, dyspareunia, vulvodynia, painful intercourse, gynaecological pain, sexual dysfunction, chronic pelvic pain) for the purpose of education and collaboration; it’s not therapy or medical advice. Information is general in nature and does not replace individualised assessment or treatment advice. Please seek professional support tailored to your specific needs. If you or someone you know is in crisis and needs help now, call triple zero (000). You can also call Lifeline on 13 11 14 — 24 hours a day, 7 days a week. Please see our About page for more information.