"The long term side effect of sexual assault I'd never heard of." 

“It hurts in a way that’s really hard to describe…” I said to my doctor just after lunchtime on a Monday.

“The pain is sort of, muscular? I’ve googled it and I couldn’t find anything,” I mumbled, looking down at my clammy hands, immediately embarrassed that I’d admitted to googling my symptoms before coming to the doctor. “It’s not just at the beginning of sex either,” I quickly added. “It’s also when I go to put a tampon in, and my last pap smear really hurt.”

I’d always suspected that maybe I just had a really low pain threshold, and that’s why I fainted when I kicked my little toe on a coffee table, or wanted to yell very loudly whenever I accidentally bit my tongue.

But something told me this wasn’t entirely normal.

I couldn’t remember the precise moment it started, I explained to the doctor; maybe three years ago? Four? Sex certainly hadn’t always been uncomfortable, but it was like something had happened, and all of a sudden I was – for lack of a better term – clamping up.

She looked at me like I was a puzzle she had proudly worked out.

“You have vaginismus,” she said.

Unlike most, I actually knew exactly what vaginismus was. The condition is typified by painful intercourse, sometimes making penetration difficult or impossible. It also manifests in painful tampon insertion and gynaecological exams.

LISTEN: Why so many women aren’t getting pap smears. We discuss on Mamamia Out Loud. 

The muscle spasms that cause the discomfort are involuntary, and therefore no amount of “just relax” will fix the problem. It is also believed the condition is psychosomatic, meaning the psychological state manifests the physical symptoms.

What I didn’t understand, however, was why this had happened all of a sudden. The women I knew who lived with vaginismus had struggled to have sex in the first place – not just out of the blue at the age of 23.

That’s when the doctor asked if I’d ever experienced sexual assault.

“Oh. Yeah there was one experience,” I said. “I was attacked on a street, but it wasn’t penetrative or anything, so I don’t think that could be it…”

I was referring to an incident that took place in 2014, during a late afternoon in winter.

My twin sister and I had done some grocery shopping and were walking home together, talking about nothing in particular.

We both noticed a fairly normal looking young man heading towards us, and I recall giving him a nod of acknowledgement. He didn't make me feel uneasy - but, as women do - I noticed him.

As we passed each other, myself on the right, closer to the houses, the man attacked me.

At first I thought he wanted what was in my bag, perhaps my wallet. I tried to hand over the bag, but he wasn't going for my belongings. He was going for me.

He pushed me into the driveway, now out of view of the street, and put his hands down my jumper and inside my bra. I pushed him away as strongly as I could, and it did not make any difference.

My sister yelled and yelled, and although there were people in the street, now watching this bizarre series of events unfold, no one did anything.

Although I don't remember what he was wearing, or what he looked like, I do remember very vividly what I thought. I believed - for the first, and hopefully the last time in my life - that he was going to rape me, and then kill me.

At that point, my sister was on the phone to the police, yelling at him that they were on their way.

He started laughing, stood up, pulled his pants down and started masturbating, centimetres from my face. He looked from me to her, madly laughing.

I took this moment to run, and he ran in the opposite direction.

"This is not, however, where the story ends," I wrote a few years ago, referring to the subsequent psychological damage this violence inflicted.

I've not quite felt safe on the street since. I flinch when a man walks past me, envisaging a terrifying side step.

But what I didn't know then, was that I was also living with physical side effects.

Assault, of course, doesn't have to be penetrative to impact a person long-term. The doctor explained that rape, assault, or attempted assault, are among the most common causes of vaginismus. And interestingly, when I connected the dots, my symptoms had begun in the months after the attack.

You can listen to the full episode of Mamamia Out Loud, here. 

Other factors that may contribute to vaginismus include witnessing rape or sexual assault, physically invasive trauma (not necessarily genital), generalised anxiety disorder, witnessing domestic abuse in early childhood, a conservative sexual education that leads to shame and negative emotions towards sex, urinary tract infections, and vaginal yeast infections.

Associating the vagina with any sort of pain (as might be caused by chronic yeast infections) can lead to conscious - or, in my case, unconscious - fear around penetration.

It must be said, my case of vaginismus is relatively mild. I can still function, albeit with some discomfort. But there are some women who cannot use a tampon, or are left in excruciating pain after sex - if they can even have sex at all.

We talk about the horror of sexual or indecent assault, focusing on the granular details of the event itself.

For many women, however, it's the aftermath that's even crueller. And it's a healing process that might not have an end in sight.

If you or someone you know has experienced sexual assault, please seek help with a qualified counsellor or by calling 1800 RESPECT.