Yes, It’s Real. And Nobody Talks About It.

By Dr. Avanthi Vellala

She was 37. Eight years of marriage. And in all those eight years, they had never been able to have penetrative intercourse.

The condition is called vaginismus. The pelvic floor muscles involuntarily contract whenever penetration is attempted as an automatic physical response that the person has no control over. It causes pain. It causes fear. And because the fear of pain builds over time, it creates a cycle that becomes harder and harder to break.

The emotional weight of this is enormous. Couples stop trying. Women start avoiding intimacy altogether. And because nobody talks about it not doctors, not partners, not friends. Most people suffer through it in silence for years.

Studies suggest 1 in 6 women experience vaginismus of some grade. That number is not small. The silence around it is.

This couple had visited multiple doctors over the years. They had tried fertility treatment on and off.

By the time they walked into my clinic, they were 37 and anxious. The biological clock and the social clock were both ticking and they knew it. They wanted a baby. They had always wanted a baby. And now time was becoming a real factor.

Clinically, there was good news. Her AMH was good, ovarian reserve was good, semen parameters were normal. No major issues on either side. The problem wasn’t biology, it was time and years of something going unaddressed.

Given their age, IVF was the right call. We started stimulation.

She prepared herself mentally for scans. Never once complained though I could see the discomfort in her face

16 expected. 19 retrieved. 11 mature. 10 fertilised. We used microfluidics for sperm selection.

By day five we had four embryos. Average to poor quality.

This is what age does. We retrieved 19 eggs and ended up with 4 embryos of limited quality. The numbers were good at retrieval. They weren’t good by the end. That’s not a failure of the cycle that’s the honest reality of what happens to egg quality as we get older. It’s undeniable and it’s why I talk about this so often.

We had planned PGT genetic testing of the embryos but couldn’t proceed because of the quality. We decided to transfer the two best a 3CC and a 4CC embryo.

This couple had never tried before. No prior transfers, no prior failures. I wanted to give them that first real attempt.

They conceived. They delivered a baby boy.

They came to show me the baby shortly after delivery. And while we were sitting together, they said something that stayed with me.

“People were judgemental when we went to other clinics. But you gave us a beautiful baby in the first attempt.”

I didn’t know what to say. I’m still thinking about that word. Judgemental. People fear being judged but that’s not the case when you are at the right clinic.

We address vaginismus from the very beginning. Most couples, with the right support, overcome it within 3 to 6 months and go on to conceive naturally. I don’t always do IVF

Some time later, I was talking to my husband about this case. He is an entrepreneur, has an HR background, is well read, health-aware, and has been around medicine long enough to know a great deal. He is one of the most open-minded people I know.

He had never heard of vaginismus.

He was shocked. Not in a dismissive way in a genuinely stunned way. That a couple could stay together for eight, ten years without consummating their marriage. That this was a real, named, treatable condition that most people had never encountered the word for.

And I was surprised by his surprise. Because if someone like him informed, open, medically adjacent had never come across this, what does that say about how little we talk about it?

Sexual disorders are still a taboo. Vaginismus especially so because it sits at the intersection of physical pain, emotional shame, relationship silence, and medical neglect. People don’t bring it up. Doctors sometimes don’t either.

1 in 6 women. That’s the number. And most of them are sitting with it alone.

If any of this sounds familiar identification and acceptance is where it starts. Psychotherapy, counselling, anxiety management, vaginal dilators, lubricants there are real options. It is treatable. You don’t have to carry this quietly.