Vaginismus: causes, symptoms and treatments

Health Tips

Vaginismus is a sexual pain disorder characterized by involuntary spasm or contraction of the vaginal muscles during any attempt at penetration, accompanied by pain. Most often this happens during intercourse. However, women with vaginismus may experience pain not only during sex, but also during non-sexual activities, such as inserting a tampon or taking a vaginal swab during a pelvic exam.

This condition can occur in a woman at any stage of her life, both in adolescence, for example, when she first tries to use a tampon, and later, after the normal course of sexual life, for example, after childbirth.

Vaginismus can also develop as a result of thrush, sexual trauma, or menopause. Some women find themselves suffering from vaginismus when they fail at their very first sexual encounter.


Involuntary contraction of the vaginal muscles is the main symptom of vaginismus, but the severity of this condition can vary and is often accompanied by burning pain. In all cases, narrowing of the vagina makes penetration difficult or impossible during intercourse, tampon insertion, gynecological examination, and intravaginal ultrasound. Contrary to popular belief, pain during sex or insertion of a tampon is not normal and should be seen by a doctor.

At the same time, vaginismus does not at all mean an unwillingness to have sex and is not an indicator of a woman’s lack of arousal – it is penetration that causes fear. Women diagnosed with vaginismus are able to experience sexual pleasure and orgasm.

Causes of vaginismus

It is believed that vaginismus is a psychological problem, the causes of which lie in our heads. The trigger for this condition can be fear and negative emotions associated with sex, increased anxiety, the experience of painful sexual contact or trauma in the past, as well as a number of other emotional factors that are individual for each woman.

Certain physical conditions, such as thrush and urinary tract infections, can make the symptoms of vaginismus worse.

For some women, the symptoms of vaginismus can be brought on by menopause. The fact is that after menopause, with a decrease in estrogen levels, the lack of natural lubrication reduces the elasticity of the vagina and makes sexual intercourse painful, full of discomfort and stress, and sometimes even impossible. This condition is called atrophic vaginismus.

However, there are times when vaginismus can occur on its own and no direct cause can be found. In any case, only a doctor can make a diagnosis by examining the anamnesis and conducting an examination.

Diagnosis of vaginismus

Diagnosis usually begins with the patient describing the symptoms. Most likely, the doctor will ask when you first noticed the problem, how often it occurs, and what is the trigger. The specialist may also ask you to give a brief history of your sex life, ask questions about sexual trauma or abuse. Next, the doctor proceeds to a gynecological examination.

Usually women are very nervous before such an examination. Therefore, try to agree in advance with the doctor on how to make it less traumatic and more comfortable. So, for example, some women prefer examination on the couch, and not on the chair, others bring a mirror with them to see what manipulations the doctor is carrying out.

When a doctor suspects vaginismus, they usually do the examination as carefully as possible. Some gynecologists sometimes even allow patients to guide their hands or medical instruments into the vagina to facilitate penetration. You can also ask your doctor to walk you through each step of the exam as you go through it.

The purpose of a pelvic exam is to detect or rule out signs of infection or scarring and check the vagina for inflammation. Often, vaginismus can be confused with vulvar vestibulitis, which is caused by inflammation of the vagina that is only painful during penetration and is usually asymptomatic. Vaginismus does not have any physical causes. This is one of the key criteria for making a diagnosis.

If you have been diagnosed with vaginismus, this is not a reason to refuse sexual pleasure, because many intimate activities do not involve penetration, such as oral sex, massage and masturbation.


The good news is that vaginismus is a completely treatable disorder. His treatment is complex and usually includes educational and psychological support, as well as special exercises.

Educational support consists in studying the anatomy of the genital organs and what happens to them during sexual arousal and close intimacy. You will also receive information about the muscles involved in vaginismus.

Psychological support is usually provided by a specialist who specializes in sexual disorders. These classes are conducted as a course and are based on the principle of psychotherapy. In addition to educational and psychological support, relaxation and hypnosis techniques have worked well for some women.

Vaginal dilators

For some women, special vaginal dilators are effective in combating vaginismus and should be used under the supervision of a specialist.

A cone-shaped dilator is placed in the vagina and begins to gradually increase in size. This, in turn, helps the vaginal muscles stretch and become more elastic.

Kegel exercises

These exercises alternately contract and relax the pelvic floor muscles that control the vagina, rectum, and bladder. It is possible to correctly determine which muscles are involved in this exercise during urination. If immediately after the start of urination you try to stop the stream, you will immediately feel how the muscles of the pelvic floor are included in the work. This group consists of 21 muscles that move, contract and relax at the same time. You can work these muscles by doing the following:

  • empty your bladder;
  • contract your pelvic floor muscles and count to 10;
  • Relax your pelvic floor muscles and count to 10 again.

Do 10 repetitions three times a day.

Photo: Vostock-photo

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