Vaginismus

What Is Vaginismus?

Vaginismus is when the muscles of a woman’s vagina squeeze or spasm when something is entering it, like a tampon or a penis. It can range from mildly uncomfortable to quite painful.

 

Vaginismus Types

There are two main types of vaginismus.

Primary

This is when a woman has had pain every time something entered their vagina, including a penis (called penetrative sex), or when they’re never been able to insert anything into their vagina. It’s also called lifelong vaginismus.

Secondary

This is when a woman has had sex without pain before, but then it becomes difficult or impossible. It’s also called acquired vaginismus.

Vaginismus Symptoms

Painful sex (dyspareunia) is often the first sign of vaginismus. The pain happens only with penetration. It usually goes away after withdrawal, but not always.

Some women describe it as a burning or a feeling like the penis is "hitting a wall."

Many women who have vaginismus also feel discomfort when inserting a tampon or having a pelvic exam at their doctor’s office.

Other symptoms of vaginismus include:

  • Not being able to have penetrative sex or insert a tampon at all
  • Fear of pain or sex
  • Loss of sexual desire

These symptoms are involuntary, meaning a woman can’t control them without treatment.

Vaginismus Causes

Doctors don't know exactly why vaginismus happens. It's usually linked to anxiety or fear of having sex. But it's not always clear which came first, the vaginismus or the anxiety.

Some women have vaginismus in all situations and with any object. Others have it only in certain cases, like with one partner but not others. Or they might have it with sexual intercourse but not with tampons or during medical exams.

Other health problems like infections and dryness can also cause painful intercourse. It's important to see a doctor to find out what’s causing it.

Vaginismus Diagnosis

Your doctor will ask about your symptoms and your medical and sexual history.

They’ll do a pelvic exam to look for other health conditions that could cause pain. You might need some treatment before you can tolerate the exam. Your doctor will move as slowly and gently as possible, and they’ll explain everything they’re doing.

Continued

Vaginismus Treatment

Women with vaginismus can do exercises at home to learn to control and relax the muscles around their vagina. This is called progressive desensitization, and the idea is to get comfortable with insertion.

First, do Kegel exercises by squeezing the same muscles you use to stop the flow when you’re peeing:

  • Squeeze the muscles.
  • Hold them for 2 to 10 seconds.
  • Relax the muscles.

Do about 20 Kegels at a time. You can do them as many times a day as you want to.

After a few days, insert one finger, up to about the first knuckle joint, inside your vagina while doing the exercises. You might want to clip your fingernails first and use a lubricating jelly. Or do the exercises in a bathtub, where water is a natural lubricant.

Start with one finger and work your way up to three. You'll feel your vagina's muscles clenching around your finger, and you can always take your finger out if you're not comfortable.

After a while, you’ll be able to put cone-shaped inserts into your vagina for 10 or 15 minutes to help your muscles get used to pressure.

For women whose vaginismus is linked to fear or anxiety, therapy often helps.

WebMD Medical Reference Reviewed by Nivin Todd, MD on March 22, 2020

Sources

SOURCES:

Merck Manual for Health Care Professionals: "Vaginismus."

Society of Obstetricians and Gynecologists of Canada web site: "When Sex Hurts -- Vaginismus."

Goldstein, A. Pukall, C., Goldstein, I., editors. Female Sexual Pain Disorders: Evaluation and Management, Wiley-Blackwell, 2009.

Indian Journal of Psychiatry: “Successful management of vaginismus: An eclectic approach.”

Health Service Executive (Ireland): “Vaginismus.”

Medscape: “Vaginismus: A Review of the Literature on the Classification/Diagnosis, Etiology and Treatment.”

Merck Manual Consumer Edition: “Dyspareunia,” “Vaginismus.”

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