All About Vaginismus

All About Vaginismus

What is Vaginismus?    

Vaginismus is a condition where the vaginal muscles contract and close up as a result of involuntary spasms of the pelvic floor muscles. And when this happens, any kind of vaginal insertion, whether it’s a penis, simple tampon, or a regular gynaecological examination tool become almost, if not completely, impossible.

The condition is always associated with some form of pain ranging between mild and severe. Even when it’s not that painful but simply uncomfortable, vaginismus can chip away at a woman’s self-esteem. Sexually active or not, the idea that she’s physically unable to have sexual intercourse, in addition to not being able to use a simple item like a tampon, can be substantially daunting for a woman. When this happens, the vaginal opening and inner walls could close down so tightly that men who’ve experienced this with their female partners have often called the sensation as “hitting a wall.” This is a condition that needs to be resolved, one way or another.    

Vaginismus is a painful condition in the pelvic floor muscles. It can happen during a Pap test, sexual intercourse, or when you try to insert a tampon into the vagina. Normally, there are two types of vaginismus: primary and secondary.[1]

Primary vaginismus refers to pain experienced during the first attempt to have intercourse while secondary vaginismus occurs to a woman used to sex. This can affect a couple’s sex life and makes pelvic examinations difficult. Read on and learn more!

Vaginismus in detail    

But before we can get to how women can avoid and treat this condition, we have to know about the different types of vaginismus and the causes that lead to their development.[2]   

Types Of Vaginismus    

The condition is classified based on their frequency and source of occurrence.

These are:   

– Primary[3] 
– Secondary 
– Global
– Situational Vaginismus    

Primary: When it comes to the “length of stay,” this is the worst kind. The Primary vaginismus type has always been there without the woman being actually aware of it since it grew familiar with time. It’s almost always experienced vividly for the first time during her first sexual intercourse.[4] The pain is always clearly noticeable and often makes it really hard to breathe.[5]

Secondary: The Secondary type vaginismus is more of a developed issue than a preexisting one. It always results from a specific situation experienced at any stage of life, even if the woman has a history of past fluent sexual activities.[6]

Global: While the Primary vaginismus lurked about without giving itself way, the Global type is very good at letting its presence known. Women with this form of vaginismus will feel it triggered by any item that even approaches their vagina. It’s always present and always noticeable.

Situational: This type is triggered only by specific events or items. For instance, women might feel their vagina close up during sexual intercourse, but not during a gynaecological examination and vice versa.

Causes of vaginismus    

Vaginismus can result from emotional and/or physical conditions. This is a potent combination since thinking about a probable physical condition could create enough metal anxiety to actually trigger the event. Anyway, let’s look at the reasons more in detail.    

Emotional Causes: Emotional causes could be like: 

– Fear of pain, side effects of intercourse and pregnancy 
– Anxiety resulting from personal guilt or performance issue 
– Condition of relationship with the partner, especially if he’s abusive or makes her feel vulnerable 
– Sex-related traumatic experience like rape or witnessing something like that 
– The portrayal of sex during the adolescent years    

Physical Causes

Physical causes are more easily traceable: 

– Various vaginal infections 
– Cancer or such invasive conditions 
– Childbirth, caesarean childbirth and pelvic surgery 
– Menopause 
– Vaginal dryness, naturally occurring or due to lack of adequate stimulation and foreplay 
– Side-effects of current medications taken    

Treating vaginismus

Once it’s actually occurred, regardless of the type, you can’t avoid vaginismus. You can, however, treat it using various methods, which will prevent any of its future occurrences. Usually, following any or a combination of the following steps should treat the condition. Remember, it’s extremely rare where actual surgery is needed, so don’t feel frustrated just yet.    

Kegel Exercises: This is a very common and familiar exercise where the pelvic muscle is voluntarily contracted and relaxed. It targets the one that you use to stop the flow of urine. Kegel strengthens the pelvic floor muscles against involuntary spasms.[7]

To do the exercise, contract and hold the said muscles for 2 to 10 seconds and then release. Every 20 repeats make up a set. You can perform as many sets a day as you want.

Physical and Psychological Counselling: Physical or sex education will help you understand our sexual anatomy and response cycle better, resolving any misconception-based performance anxieties. Psychological counselling, on the other hand, would resolve emotional factors related to identity crisis and self-esteem.[8]

Insertion Method: This is the most direct route to treating vaginismus. Kegel is a prerequisite here. After performing the exercise for a few days, gently force a finger into your vagina down to the first knuckle joint and start doing the Kegel again. Don’t forget to clip your fingernails and use adequate lubrication.[9]

Vaginal dryness is a common accomplice of vaginismus. Work your way up from there until you reach three fingers; if not in one, then as many days as you can allow. You should be able to feel the inner walls pressing in on your fingers. Take them out if it gets too uncomfortable. Repeat the exercise until your vagina becomes accustomed to permitted invasion.

You can facilitate the exercise further by getting a cone-shaped medical dilator. Insert it into your now-relaxed vagina and keep the device in place for 10 to 15 minutes. Once it completely stops hurting, you can get a bigger insert for further conditioning.    

Avoiding Vaginismus    

As said earlier, you can’t avoid the issue once it’s already occurred. You can, however, do that to some extent if you take some precautions.

Nutritional Supplements: Infection is one of the leading physical causes of vaginismus and is almost always caused by an imbalance in vaginal health. The vagina is home to over 50 microbes, many of which are called lactobacilli.

These beneficial bacteria are necessary for maintaining a healthy balance and ward off various infections. Probiotics supplements with lactobacillus acidophilus create a healthy environment that resists against infections stemming from changes in hormones, unprotected sexual intercourse with a man, period, and bad hygiene. So indirectly, these probiotics help in avoiding vaginismus.

In addition, you can also include Shatavari, a type of Indian asparagus, into your diet. Shatavari is good for maintaining vaginal health and natural wetness.[10]

How common is vaginismus?

While the exact number of women with this condition is unknown, it mostly affects those above 20 years. More clearly, vaginismus affects 5-17% of the women population. In other words, two out of a thousand women have vaginismus.[11] Still, this number could be higher. Let’s try to break this down even further. About 0.2% of the population in the U.S. suffer from this condition. According to Dr Harold from the University of Pennsylvania, this number could be higher. Out of the vaginismus patients in the USA, 47% are single or dating, while 53% are married. Needless to say, 18% of the patients are in their 20s, 53% are below 35 years, and 26% are between 36-50 years.

It’s worth mentioning that vaginismus can be shared by women across all cultures, irrespective of their education levels or religious affiliations. Most of them suffer in silence due to shame and embarrassment.

How is it diagnosed?

This condition is diagnosed by performing a pelvic exam. It’s based on the medical and sexual history of a woman. Before the process begins, the doctor will explain the procedure. In some cases, you’ll be given a mirror to check your genitals.[12] Besides that, the doctor may suggest a pelvic examination, which may involve inserting fingers or other instruments in your vagina. But prior to the exam, you’ll be asked if you’ve been a victim of sexual abuse. Other questions may include; can you tolerate anything penetrating through the vagina? Are you sexually active with your partner?

Although it’s normal to get nervous during the exam, the doctor will ensure he or she makes the process as comfortable as possible. The simplest way to conduct the examination is spreading the labia and inserting a gloved finger past the hymen. While vaginismus usually comes with no abnormalities, the doctor will look for infections and scars. Your general practitioner may also refer you to a gynaecologist.

Is it possible to heal from vaginismus?

Yes. Once it’s diagnosed early, a sex therapist will use different methods to combat the problem. One of the most effective ways is emotional therapy. Here, the patient expresses herself and tries to get rid of the anger that may be causing the problem.[13]

Secondly, the patient undergoes sexual counselling. You’ll be taken through the anatomy of the reproductive system. In addition to that, you can be given lessons to address the root cause of the problem.

Another effective treatment method is dilation and insertion training. These are a series of exercises to help you become accustomed to penetration. The most effective workout is a pelvic floor exercise. Patients perform Kegel exercises, which involve relaxing and tightening vaginal muscles and most importantly controlling the bladder.

The specialist may choose to treat any infection before focusing on vaginismus. It’s important to underscore you in order not to let fear stop you from seeking medical attention. Also, the time it takes to complete the treatment can vary from one individual to the other. In very rare cases, this condition may need surgery.

Is vaginismus dangerous?

Women with vaginismus experience debilitating pain and may have difficulties allowing a penis or any other object in their vagina. While there is no bodily harm, they are affected psychologically. Other than that, there’s a risk that the vagina may get torn. Occasionally, a woman who has ever been sexually assaulted has fear. The danger comes in if there are other underlying problems like urinary tract infection, thrush, fissures, or the aftermath of a vaginal delivery. This can be a nightmare for couples in a relationship.

Without lubrication, you may experience a burning sensation or irritation. Not to mention, the pain can be too much, making it hard to go through the gynaecological exam. Preliminary studies suggest that ladies with vaginismus[14] are at a higher risk of getting STIs. What’s more, women in their menopause will feel pain during sex due to hormonal-related dryness.

Truth be told, sex should not be dreadful. To make it more enjoyable, you can add lubricants or even change to a comfortable position. If you’re looking for tangible results, be sure to work on your nerves around the vaginal region. Of course, it’s important that you consult your doctor to cure your pain.

Remember, vaginismus is not an irregular phenomenon and must not be treated as an embarrassing condition. Depending on the individual, the treatment(s) takes time to become effective. However, it’s a mostly curable and manageable condition.

[1] Reissing ED, Binik YM, Khalifé S. Does Vaginismus Exist?: A Critical Review of the Literature. J Nerv Ment Dis. 1999;187:261–74



[4] Peleg R, Press Y, Ben-Zion IZ.. Glyceryl trinitrate ointment as a potential treatment for primary vaginismus. Eur J Obstet Gynecol Reprod Biol. 2001;96(1):111–2.



[7] Wijma B, Wijma K.. A cognitive behavioural treatment model of vaginismus. Scand J Behav Ther. 1997;26:147–56.

[8] Thorburn J. Vol. 1. Charles Griffin and Company: London, UK: 1885. A practical treatment of the diseases of women; pp. 1–10.


[10] Harrison CM.. Vaginismus. Contracept Fertil Sex. 1996;24:223–8.


[12] Lew-Starowicz Z. Results of treatment of women with diagnosed vaginismus. Ginekologia Polska. 1982;33:691–4.