They want to make love, but can not do it. They have desires, desire for each other, but can not satisfy them. In question, a pathology of which we speak little, because shameful for those who suffer: vaginismus.

"It is a psychosomatic sexual and gynecological disorder, but which, contrary to what we think, is not only feminine, it is more of a couple's pathology," explains Dr. Odile Bagot * Clinically, it is a reflex contracture of the perineal muscles, which prevents any penetration, whether it is a tampon, a finger, and even less a penis, making any sexual relation or impossible gynecological examination.This is a couple composed of an 'impenetrable', and an 'impenetrable'. "

Very widespread, primary vaginismus (there are two forms) affects about 1 couple out of 200 in France. "Unfortunately, women who are affected often think that this is their fault, and that this pathology is incurable.It must be explained that this is not the case," reassures our expert.

"This is the story of a sex visitor who does not dare and a sex visited who would like to welcome, but who can not" **

For them, penetration, not sexuality, is a real phobia lived in a totally unconscious way. "Their brain integrates the idea that penetration is linked to pain, which then triggers this rejection reflex that they can not control, even with the best of intentions," describes Odile Bagot.

"On my wedding night in July 2008, penetration is impossible, I put that on the count of stress , fatigue , my modesty.But the more days go by, the less it works", confides Justine ** *, 32, still a virgin at the time of her marriage.

When my husband's penis approaches my vagina, I feel an unbearable burn

Worried, the young woman then consults a sexologist on the advice of her gynecologist. "And there the verdict falls: 'You suffer from vaginism', all this is so new and incomprehensible to me since I have never been confronted with sexuality".

A situation which, according to her, would have "pushed" her husband into adultery a year later: "He did not apologize, he totally assumes his choice, he needed it, I felt guilty, but At the same time I was really hurt, it was the worst betrayal for me, because I had total confidence in him, and after that we reached an agreement: he told me that I had to make an effort without talk about penetration, but at least sex, that it would not deceive me anymore but that I had to move or it would be over.I had a hard time getting physical contact with him again, I could not I did not want to heal for him anymore. "

There follow years of wandering punctuated by the consultation of various specialists. But when Justine manages to take a step forward, she immediately makes two back. "One day, the penis arrives to return, finally! And without pain! Then I tell myself that it is there, I am cured! But the next day I have pain again. We try again, then nothing. I do not talk about it, we do not talk about it anymore (...) I do not see why I should try hard for something that gives me nothing but pain. "

Ten years after the diagnosis, Justine gets to have sex with penetration but says "do not feel" anymore. "I have no desire, the libido to 0. I sometimes have fun and even orgasms, during the preliminaries.I think the problem is that after ten years, the the flame of the beginning was extinguished, the routine was installed, and above all, the penetration became boring and without interest. "

The fact that I do not manage to have a 'normal' sexuality makes me feel ashamed. I am ashamed of myself, of what I am, ashamed of not being able to satisfy my husband. I feel guilty a lot. I do not feel like a woman, I do not trust myself.

"You have to deal with the problem early and do not bury your head, do not let things get bogged down."

Vaginism: how to overcome it?

Promising treatments include psycho-behavioral therapy with a midwife or gynecologist. A method exploited with great success for twenty years by Odile Bagot in his consultation.

"The goal is to decondition this reflex, explains the gynecologist.After an interview, we set up a session of relaxation and sophrology to teach the patient to relax in a general way.Here she is encouraged to develop all the possibilities of her alternative sexuality with prohibition of penetration, in this way she can develop her sensuality, and therefore her sexuality, and we encourage her to massage herself as well.

Then we ask her to visualize and feel what is going on in her perineum, an area that most women do not know at all. She thus causes her brain to feel something she has completely obscured.

In the third session, it is placed on a chair and simply put his hands on the inside of the thighs and knees, then back gently to the vulva. Some do not necessarily tolerate it. You have to go little by little. If possible, the hymen is very lightly spread out (in the case of a still virgin woman). And if she supports it, the next step is to introduce a vaginal dilator called Hégar Candle. As it is very thin, it does not cause stretching of the hymen. The woman is then asked to remove her herself, and this is very often a revelation. She removes it and then becomes aware of the depth of her vagina. Session after session, his perineum no longer sends him messages of 'pain'.

Once she is successful, I ask her to do it alone at home, but also that her partner does it for her. This then allows to test the confidence that the woman has in her partner. He, often clumsy during unsuccessful attempts at sex, can feel the direction of the vagina. At each session, we pass candles of increasing size. "

The important thing is not to force things, and the sessions usually do not last more than 5 minutes. Nervously, the woman takes a lot on her at these times.

"That's the way we get to the last candle, which is practically the size of an erect sex, and then I ask the partner to be present during the session and explain to him how he is going to have ' replace the candle.As it is a situation that can be stressful, I encourage him not to formalize if he has a hard time getting an erection: it does not matter, if it does not work today Tomorrow it will work tomorrow I explain to him that he must position himself in front of the vulva, press gently, and go in. When there is no other particular problem in the couple, then they are quickly 'cured'. Of course, the woman will not have a vaginal orgasm the next day, but everything will return to order as the life of the couple changes dramatically.

This technique can also be coupled with sessions with other specialists such as a psychologist, sexologist, physiotherapist or osteopath ... The goal is to do a double work on his body, but also in his head.

Ask something about aches and break the isolemen t

Beyond treatments, the importance of support from other patients is essential for these women, who often close themselves little by little.

For a long time I felt abnormal, different, deficient. It seemed to me that I had failed somewhere but I did not know where exactly.

"I did not understand what was happening to me, why I had never heard of it before, why nobody around me had ever heard of it, was I so abnormal?" says Laura, 28 years old. A feeling shared by Sarah, 42 years old. "Being alone in the conjugal room, not being able to 'get' anything in her vagina, to suffer physically, to cry, to feel devalued by failure: all this made me plunge into despair."

A situation well known Aurélie Jaffrelot, President of the Association "The Keys of Venus", founded in 2009 to support women with dyspareunia (sexual pain). ****

"Thanks to our actions, we want women to re-appropriate their sexuality, their bodies, and they do not feel alone anymore," she says, "we are often the first link because this disease is shameful. She touches on intimacy and this is not the kind of thing we talk about with her surroundings.

We live in a very sexualized society, with norms, performances and there is no place for these women. They are also often cataloged as frigid, as not wanting.

"Putting a name on this disorder and discovering that there is an association can really be liberating for them."

And to add: "With the association, we bring them reliable information, validated by health professionals who are accustomed to diagnose, take charge of vaginismus (gynecologists, sexologists , midwives, psychologists, dermatologists, physiotherapists, osteopaths ...), and to whom we direct them via a directory.We want to avoid a therapeutic wandering that can sometimes last for years.With this information, women are less likely to come across someone who tells them, as was the case for me, 'you have to relax, it's nothing, it's in your head', 'you realize what you are doing to your husband', or 'you are leading a abstinence for your husband. "If they can avoid this kind of talk, it's less trauma."

Support that manifests itself in various ways: "We carry out daily mutual aid actions through professional conferences or convivial meetings during which women can share their experiences.These are ways of giving women up-to-date information on the topic and to expose them new ways of treatment.We also set up a free hotline once a month with a sexologist for our members. "

Secondary vaginismus, a less common form

Much less common, secondary vaginismus is for women who have recently given birth, for whom there has sometimes been a lot of time without sex, or who may have had an episiotomy .

"Even though the scar is no longer really painful, the sensation is that it has a secondary vaginismus and it is common that the arrival of a baby does not necessarily promote a 'normal' sexual recovery. These are psychic cases, with a somatic starting point, but these cases are much rarer and are usually resolved by themselves, "concludes the gynecologist.

Other possible causes: repeat vulvovaginitis, vestibulodynia or treatments against hormone-dependent cancers ( breast , uterine , ovarian cancers ), which induce early menopause . Deprived of hormones for life, many women suffer from atrophic vaginitis and associated serious side effects ( vaginal dryness , gynecological infections, pain during intercourse ...). Problem: the treatments are reimbursed to alleviate the deleterious effects of menopause are based on hormones and prohibited to patients and former patients of cancer. In this regard, Rose Association has launched a petition ( petition.rosemagazine.fr) and the hashtag #cancersexemetoo in March 2018 in order to challenge the Ministers of Health and Women's Rights.

* Author of "Dico des nanas", published by Hachette Santé.
** Quote from Danièle Choukroun, midwife who worked alongside Professor Willy Pasini, psychiatrist and sexologist much publicized in the 90s.
*** The first names have been changed.
**** https://www.lesclesdevenus.org/