How to Cope with Vaginismus

PDF download Download Article
PDF download Download Article

Vaginismus is a type of female sexual dysfunction in which the muscles of the vagina contract involuntarily during attempts at sexual intercourse, causing discomfort and pain. In addition to interfering with a healthy sex life, vaginismus may prevent women from inserting tampons or having pelvic exams. Causes of vaginismus vary and are worth exploring for treatment purposes. Although the condition can be upsetting, embarrassing, and stressful, it is absolutely treatable.

Part 1
Part 1 of 3:

Identifying Vaginismus

PDF download Download Article
  1. The first and most disturbing symptom of vaginismus is pain during attempted sexual intercourse. Different women experience this pain differently--it may feel like burning, stinging, tightening, tearing, or as if your partner is “hitting a wall.” In many cases, the pain and the involuntary muscle contractions are severe enough to prevent sexual intercourse entirely. [1]
    • Many women discover this problem the very first time they attempt to have sex. This is called primary vaginismus
    • Other women develop vaginismus later in life, which is secondary vaginismus . So, it is important not to discount this key symptom just because you have been sexually active without pain in the past.
  2. In addition to pain during sexual intercourse, women with vaginismus may have trouble with other kinds of penetration, including tampon insertion and pelvic exams. Other symptoms also include: [2]
    • unconsummated marriage
    • ongoing sexual discomfort or pain following childbirth, yeast/urinary infections, STIs, IC, hysterectomy, cancer and surgeries, rape, or menopause
    • ongoing sexual pain of unknown origin
    • halted breathing during attempts at intercourse
  3. Vaginal muscle contractions and spasms are the hallmarks of vaginismus, but some women also experience spasms in the legs or lower back. These spasms occur most frequently during attempts at sexual intercourse. [3]
  4. Many women with vaginismus fall into a pattern of avoiding sexual situations. Avoiding sexual activity or romantic relationships because of pain or embarrassment about your symptoms is a clear sign that medical help should be sought.
    • Remember that this avoidance is not your fault, and is caused by your body's involuntary association of sex with pain.
  5. Make an appointment with your primary care physician or gynecologist to discuss the possibility of vaginismus. Be clear about the extent and severity of your symptoms.
  6. Your doctor should perform a pelvic exam and note any discomfort or vaginal contractions that occur. In addition, he or she will probably recommend additional tests to rule out other possible causes of your symptoms.
    • The vaginismus may have an obvious physical cause, like an infection, injury, or hypersensitive nerves at the opening of the vagina (provoked vulvodynia). [4]
  7. If all other potential causes of your symptoms are ruled out, your doctor may diagnose you with either primary or secondary vaginismus. Additionally, your doctor may describe your condition as global , if it occurs in all situations involving insertion or situational , if it occurs only in certain situations (like attempted sexual activity). [5]
    • Unfortunately, female sexuality and sexual dysfunction are not fully understood. You may run into medical personnel who dismiss your symptoms or fail to help you. In this case, be persistent about getting a diagnosis and treatment. If your doctor does not help you, see another who has experience treating vaginismus and other forms of female sexual dysfunction.
    • Other possible diagnoses are apareunia, a general term for inability to have sexual intercourse (of which vaginismus is one type), and dyspareunia, which refers broadly to pain during sexual intercourse.
    • These diagnoses will push your treatment forward, providing the opportunity to arrange a team of experts.
Part 2
Part 2 of 3:

Understanding the Causes of Vaginismus

PDF download Download Article
  1. Many women with vaginismus can trace their symptoms to feelings of anxiety, fear, and stress. These can be more deeply rooted, or simply related to current factors of life, like lack of sleep and excessive work-related stress. [6]
  2. Women with vaginismus are more likely than others to have deeply ingrained negativity about sex and sexuality. [7] These feelings may date back to childhood, or they may be related to a particularly traumatic event.
    • When negative underlying beliefs about sex start at a young age, another potential component of vaginismus comes into play--lack of proper sexual education.
  3. It is estimated that women with vaginismus are twice as likely to have a history of childhood sexual interference as non-sufferers. [8] Events thought to contribute range from mild to severe traumas, and include the following: [9]
    • sexual abuse by someone familiar
    • sexual assault
    • pelvic trauma
    • domestic violence
    • highly negative early sexual experiences with a consensual partner
  4. If you have secondary and situational vaginismus, it may be rooted in issues with a sexual or romantic partner. These issues might include a lack of trust, a fear of commitment, or a concern about becoming too vulnerable or opening yourself up to pain and disappointment.
  5. A variety of conditions may provoke or heighten the symptoms of vaginismus. This is particularly likely if your vaginismus appeared after a period of normal sexual functioning. Potential medical conditions that can contribute to vaginismus include: [10]
    • urinary tract infections and other urinary problems
    • sexually transmitted infections
    • cancer of the sexual or reproductive organs
    • endometriosis
    • pelvic inflammatory disease
    • vulvodynia or vestibulodynia
      • Medical procedures involving female reproductive organs, like hysterectomies, can also cause vaginismus.
  6. [11] For many women, the onset of secondary vaginismus is related to childbirth. This is more likely if it was very difficult or resulted in injuries to the sexual organs. Other women have vaginismus from the hormonal changes and dryness that usually occurs during menopause.
    • Secondary vaginismus can also result from a fear of having children or going through childbirth. [12]
  7. Some women never find out why they have vaginismus. They have no physical causes and no known non-physical causes.
    • Some research even suggests that symptoms of vaginismus are part of general defense mechanisms that are triggered in threatening situations. This suggests that it need not always be viewed as a primarily sexual dysfunction. [13]
Part 3
Part 3 of 3:

Treating Vaginismus

PDF download Download Article
  1. A therapist can be helpful whether or not your vaginismus is caused by emotional or psychological issues. This is because awareness of the condition itself often produces fear and anxiety before intercourse, starting a vicious cycle that exacerbates symptoms. Feelings of depression, isolation, and lower self-esteem are also common effects of the stigma of sexual dysfunction. [14]
    • Treatment outcomes are much more positive when the woman and her sexual partner are motivated, cooperative, and resolve to lessen relationship conflicts. So, a couple's psychological evaluation is a great beginning to treatment. [15]
    • If your vaginismus is connected to anxiety issues or past sexual trauma, a therapist can help you deal with these issues so you can start to move forward.
    • One particular type of therapy, cognitive behavioral therapy (CBT), can be especially helpful to some women. CBT focuses on the relationship between thoughts and behaviors, and a cognitive behavioral therapist can help you change your thoughts and behaviors regarding avoidance of sexual intercourse [16] .
  2. One treatment for vaginismus is called exposure therapy, or flooding, and it involves gradual desensitization to penetration. [17] Therapist-aided exposure to penetration is an effective treatment, even for women with lifelong vaginismus. [18] The techniques for exposure usually involve vaginal penetration exercises using dilators.
    • This is the same method used for self-treatment, with the addition of a guide who can help you continue on your own with confidence and success. [19]
  3. Ask your doctor to refer you to a physical therapist who has experience dealing with vaginismus and other forms of female sexual dysfunction. Because the muscles of the pelvic floor play such a major role in vaginismus, physical therapy is one of the best treatment options. Your physical therapist might: [20]
    • teach you breathing and relaxation techniques
    • help you learn pelvic floor muscle contraction to control your pelvic floor muscles
  4. [21] Kegel exercises are designed to help you control the muscles of your pelvic floor. To do a Kegel exercise, you simply contract the muscles you would use to stop the flow of urine, hold for a few seconds, then relax. Aim to do about 20 contractions at a time, as many times a day as you can.
    • Some doctors recommend doing Kegel exercises with a finger inserted into your vagina (you can work up to three fingers). Using your finger allows you to feel the muscle contracting in order to better control its movements.
  5. Your doctor may recommend vaginal dilators to use at home. These are cone-shaped instruments that are placed in the vagina. They get progressively larger, enabling the muscles of your vagina to stretch and become accustomed to penetration. [22]
    • To begin, bear down as you would when having a bowel movement. This helps enlarge the vaginal opening. Then, insert fingers (not the dilators yet) into your vagina, continuing to push or bear down.
    • When you begin using the dilators, leave them in for 10 to 15 minutes. The vaginal muscles will become used to the pressure. [23]
    • If you have a spouse or partner, you may want to ask this person to help you insert the dilators. [24]
  6. Women with vaginismus need to be patient and try treatment options before jumping into sexual intercourse. If you try to become sexually active right away, you may experience pain or discomfort, and this sets you up for a cycle of pain and anxiety that worsens vaginismus. It is vital that you have a patient, supportive partner.
    • When you do try to have sex, go very slowly, use plenty of lubricant, and experiment to find the most comfortable positions.
    • Doctors typically suggest that women hold the penetrative object and place it partially or completely in their vagina as they have done with vaginal dilators. This applies equally to penises, dildos, and vibrators. [25]

Expert Q&A

Ask a Question
200 characters left
Include your email address to get a message when this question is answered.
Submit

      Video

      Tips

      • Some women feel so embarrassed or ashamed of their condition that they do not seek treatment for vaginismus. If you feel this way, remember that vaginismus is not your fault and that the condition is very treatable. Find a sympathetic physician and a good therapist, and work toward having a healthy sexual life.
        Thanks
        Helpful 1 Not Helpful 0
      • Some doctors and websites may recommend medications, including local anesthetics, to treat vaginismus. In general, though, this isn’t a good idea: local anesthetics will numb external pain, but they will do nothing to solve the problem itself and may make it more difficult for you to overcome the condition.
        Thanks
        Helpful 0 Not Helpful 0
      Submit a Tip
      All tip submissions are carefully reviewed before being published
      Name
      Please provide your name and last initial
      Submit
      Thanks for submitting a tip for review!

      You Might Also Like

      How to
      Flush Sperm Out of Your Body
      How to
      Get Rid of a Skene’s Gland Vaginal Cyst
      How to
      Tell if Vaginal Discharge Is Normal
      How to
      Treat Bartholin Cysts at Home (Plus, When to Seek Medical Care)
      Symptoms of Vulva Cancer (Plus Tips for Prevention)
      How to
      Wash Your Vagina
      How to
      Get Rid of Vaginal Itch: Home Remedies & Preventative Care
      How to
      Insert Vaginal Suppositories
      How to
      Insert Progesterone Suppositories Without an Applicator
      How to
      Make Your Vagina Smell Good
      How to
      Apply Monistat
      How to
      Get Rid of Vaginal Odor Fast
      How to
      Use Vagisil
      How to
      Heal Vaginal Tears

      References

      1. ↑ https://www.nhs.uk/conditions/vaginismus/
      2. ↑ https://www.novaivffertility.com/fertility-help/symptoms-vaginismus
      3. ↑ https://medlineplus.gov/ency/article/001487.htm
      4. ↑ http://www.nhs.uk/Conditions/Vaginismus/Pages/Diagnosis.aspx
      5. ↑ https://www.glowm.com/section-view/heading/dyspareunia-and-vaginismus/item/429#.YWXTwV5R3Ho
      6. ↑ http://patient.info/doctor/vaginismus-and-orgasmic-problems-in-women
      7. ↑ https://www.researchgate.net/profile/Rhonda-Amsel/publication/10957434_Etiological_Correlates_of_Vaginismus_Sexual_and_Physical_Abuse_Sexual_Knowledge_Sexual_Self-Schema_and_Relationship_Adjustment/links/53ff77f60cf2194bc29a8264/Etiological-Correlates-of-Vaginismus-Sexual-and-Physical-Abuse-Sexual-Knowledge-Sexual-Self-Schema-and-Relationship-Adjustment.pdf#page=72
      8. ↑ https://www.researchgate.net/profile/Rhonda-Amsel/publication/10957434_Etiological_Correlates_of_Vaginismus_Sexual_and_Physical_Abuse_Sexual_Knowledge_Sexual_Self-Schema_and_Relationship_Adjustment/links/53ff77f60cf2194bc29a8264/Etiological-Correlates-of-Vaginismus-Sexual-and-Physical-Abuse-Sexual-Knowledge-Sexual-Self-Schema-and-Relationship-Adjustment.pdf#page=72
      9. ↑ http://patient.info/doctor/vaginismus-and-orgasmic-problems-in-women
      1. ↑ https://www.healthdirect.gov.au/vaginismus
      2. ↑ http://www.nhs.uk/Conditions/Vaginismus/Pages/Causes.aspx
      3. ↑ http://www.nhs.uk/Conditions/Vaginismus/Pages/Causes.aspx
      4. ↑ http://link.springer.com/article/10.1007/s001920170035
      5. ↑ https://www.nhs.uk/conditions/vaginismus/
      6. ↑ http://psycnet.apa.org/psycinfo/2000-08960-006
      7. ↑ http://www.nhs.uk/conditions/Vaginismus/Pages/Introduction.aspx
      8. ↑ https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001760/abstract
      9. ↑ http://psycnet.apa.org/journals/ccp/77/1/149/
      10. ↑ http://psycnet.apa.org/journals/ccp/77/1/149/
      11. ↑ https://www.nhs.uk/conditions/vaginismus/
      12. ↑ http://www.nlm.nih.gov/medlineplus/ency/article/001487.htm
      13. ↑ https://my.clevelandclinic.org/health/diseases/15723-vaginismus#management-and-treatment
      14. ↑ http://www.merckmanuals.com/home/women-s-health-issues/sexual-dysfunction-in-women/vaginismus
      15. ↑ http://www.merckmanuals.com/home/women-s-health-issues/sexual-dysfunction-in-women/vaginismus
      16. ↑ http://www.merckmanuals.com/home/women-s-health-issues/sexual-dysfunction-in-women/vaginismus

      About This Article

      In other languages
      Thanks to all authors for creating a page that has been read 184,938 times.

      Did this article help you?