What is Vaginismus? How is the treatment?

What is Vaginismus?

Vaginismus is a condition involving muscle spasm in the pelvic floor muscles. It can make having sexual intercourse, having a gynecological exam, and inserting a tampon painful, difficult, or impossible.

When you try to insert an object such as a tampon, penis, or speculum into the vagina, it is stretched due to the involuntary contraction of the pelvic floor muscles.

This causes generalized muscle spasm, pain, and temporary cessation of breathing.

The most commonly affected muscle group is the pubococcycyus (PC) muscle group. These muscles are responsible for urination, intercourse, orgasm, bowel movements and childbirth.

Without treatment, it can cause frustration and distress and get worse. However, treatment is possible.

Fast Facts About Vaginismus

  • There are different forms of vaginismus, and symptoms vary among individuals.
  • The pain can range from mild to severe and cause different sensations.
  • Vaginismus can be caused by emotional factors, medical factors, or both.
  • Treatment that includes physical and emotional exercises is usually effective.

Types of Vaginismus

There are different types of vaginismus that can affect women of different ages.

Primary (Primary) Vaginismus

This is a lifelong condition in which pain is always present. It will be difficult to use tampons and undergo a gynecological examination.

It is often experienced by women during their first attempt at sexual intercourse. The male partner cannot insert his penis into the vagina. It may describe a feeling like “hitting a wall” at the vaginal opening.

There may be pain, generalized muscle spasms, and the woman may stop breathing temporarily. Symptoms are reversed when the attempt at vaginal entry is stopped.

Secondary (Secondary) Vaginismus

This develops after a woman has already had normal sexual function. It was not always available. It can occur at any stage of life and may not have occurred before.

It is usually caused by a specific event such as infection, menopause, a traumatic event, the development of a medical condition, relationship problems, surgery or childbirth.

Even after any underlying medical condition has been corrected, pain may persist if the body is conditioned to respond in this way.

Global Vaginismus

Vaginismus is always present and any object will trigger it.

Situational Vaginismus

This only happens in certain situations. It can happen during sex, but not during gynecological exams or tampon insertion.

What Are the Symptoms of Vaginismus?

Symptoms vary between individuals.

These may include:

  • Painful intercourse (dyspareunia), burning, or tension that may cause pain
  • Penetration is difficult or impossible
  • Prolonged sexual pain with or without a known cause
  • Pain during tampon insertion
  • Pain during gynecological examination
  • Generalized muscle spasm or respiratory arrest during sexual intercourse
  • The pain can range from mild in nature to severe and from discomfort to a burning sensation.

Vaginismus does not prevent people from being sexually aroused, but they may be worried about intercourse so they try to avoid intercourse or vaginal penetration.

What are the Causes of Vaginismus?

Vaginismus is a condition that can be caused by physical stresses, emotional stresses, or both. It happens especially when it becomes expectant, because the person is already expecting it to happen.

Emotional Triggers

These include:

  • Pain or fear of pregnancy
  • Worry or guilt about performance
  • Relationship issues, such as having an abusive partner or feelings of vulnerability
  • Traumatic lived events, including a history of rape or abuse
  • Childhood experiences growing up, such as portrayal of gender or exposure to sexual images

Physical Triggers

These include:

  • infections, such as a urinary tract infection (UTI) or yeast infection
  • Health conditions such as cancer or lichen sclerosus
  • Childbirth
  • Menopause
  • pelvic surgery
  • Insufficient foreplay
  • Insufficient vaginal lubrication
  • drug side effects

Sexual problems can affect both men and women. They are nobody’s fault and nothing to be ashamed of.

In most cases, treatment can help.

How is Vaginismus Treated?

To diagnose vaginismus, the doctor will take a medical history and perform a pelvic exam. Treatment may involve different specialists, depending on the cause.

Underlying causes such as infection may need to be ruled out or treated first before focusing on vaginismus.

The goal of treatment is to automatically tighten the muscles and reduce the fear of pain and to deal with any other fears that may be related to the problem.

Treatment usually includes a combination of:

Pelvic floor control exercises: These include muscle contraction and relaxation activities or Kegel exercises to improve control of the pelvic floor muscles.

Training and consultation: Teaching about sexual anatomy and the sexual response cycle can help an individual understand their pain and the processes their bodies go through.

Emotional exercises: This can help a person identify, express, and resolve emotional factors that may be contributing to their vaginismus.

Reducing sensitivity to insertion: A woman will be encouraged to touch the area as close to the vaginal opening as possible each day, without causing pain by moving closer each day. When he can touch the area around the vagina, he will be encouraged to touch and open the vaginal lips or labia. The next step will be to place the finger.

Placement or expansion training: When a woman can do this painlessly, she learns to use a plastic dilator or a cone-shaped tip. If he can sting it in painlessly, the next step would be to let the muscles sit for 10 to 15 minutes to acclimate to the pressure. Later, she can use a larger insert and then teach her partner how to apply that insert.

When the woman feels comfortable about it, she can allow her partner to put her penis near the vagina, but not inside. Once she is completely comfortable with it, the couple can have intercourse again. As with the addition, they may want to build on it gradually.

The time it takes to successfully treat vaginismus will depend on the individual.

It is very rare for vaginismus to be operated on.

Anyone concerned about vaginismus-related symptoms should speak to their healthcare provider for evaluation.

MedicalNewsToday,What you need to know about vaginismus, 2018


Basson, B. (nd). vaginismus Merck Manuals Consumer Version. Retrieved from http://www.merckmanuals.com/home/women-s-health-issues/sexual-dysfunction-in-women/vaginismus

vaginismus (2018, January 1). Retrieved from https://www.nhs.uk/conditions/vaginismus/

What are kegel exercises? (n.d.). Retrieved from https://www.nafc.org/kegel/

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