What is vaginismus?

Vaginismus is an involuntary spasm of the muscles surrounding the vagina that closes the vagina. This condition causes penetration to be difficult and painful, or even impossible. It can also happen when you try to insert a tampon into the vagina, or during a Pap test.

Types of vaginismus

Vaginismus is classified into two types:

  • Primary vaginismus: when vaginal penetration has never been achieved
  • Secondary vaginismus: when vaginal penetration was once achieved, but is no longer possible, potentially due to factors such as gynecologic surgery, trauma, or radiation.
  • Global vaginismus-Vaginismus is always present, and any object will trigger it.
  • Situational vaginismus- This occurs only in certain situations. It may happen during sex but not during gynecological exams or tampon insertion.

Some women develop vaginismus after menopause. When estrogen levels drop, a lack of vaginal lubrication and elasticity makes intercourse painful, stressful, or impossible. This can lead to vaginismus in some women.


Dyspareunia is the medical term for painful sexual intercourse. It’s often confused with vaginismus.

However, dyspareunia could be due to:

  • cysts
  • pelvic inflammatory disease
  • vaginal atrophy

Who gets vaginismus?

The exact number of women with this condition is not known, since many women are embarrassed to discuss it with their doctor. However, it is important to openly discuss this concern with a doctor as treatments are available.

This condition sometimes begins when women are in their teens or early twenties, when they first attempt to use a tampon or have sexual intercourse. For other women, it can develop later in life, after a period of normal sexual function. It can happen every time penetration or intercourse is tried, or only occur in certain situations, such as during intercourse but not with the use of tampons.

What are the causes of vaginismus?

Vaginismus is thought to be a psychological condition, although some physical conditions can contribute to it. Situations that may contribute to vaginismus include:

  • Fear of sex
  • Anxiety
  • Past sexual abuse or trauma
  • Negative emotions towards sex

Yeast and urinary tract infections can add to the pain related with vaginismus. A condition called vulvar vestibulitis can also be confused with vaginismus, since the inflammation is often not noticed until penetration is tried. After menopause, the lack of estrogen in the vagina can cause pain and discomfort, a condition called atrophic vaginitis.

Symptoms of vaginismus

Involuntary tightening of the vaginal muscles is the primary symptom of vaginismus, but the severity of the condition varies between women. In all cases, constriction of the vagina makes penetration difficult or impossible.

If you have vaginismus, you can’t manage or stop the contractions of your vaginal muscles.

Vaginismus can have additional symptoms, including fear of vaginal penetration and decreased sexual desire related to penetration.

Women with vaginismus often report a burning or stinging pain when anything is inserted into the vagina.

If you have vaginismus, it doesn’t mean that you’ll stop enjoying sexual activities altogether. Women who have the condition can still feel and crave sexual pleasure and have orgasms.

Many sexual activities don’t involve penetration, including:

  • oral sex
  • massage
  • masturbation

Diagnosis of vaginismus

Diagnosis of vaginismus usually begins with describing your symptoms. Your doctor will likely ask:

  • when you first noticed a problem
  • how often it occurs
  • what seems to trigger it

Typically, your doctor will also ask about your sexual history, which may include questions about whether you’ve ever experienced sexual trauma or abuse.

In general, diagnosis and treatment of vaginismus require a pelvic exam.

It’s common for women with vaginismus to be nervous or fearful about pelvic exams. If your doctor recommends a pelvic exam, you can discuss ways to make the exam as comfortable as possible for you.

Some women prefer not to use stirrups and to try different physical positions for the exam. You may feel more at ease if you can use a mirror to see what your doctor is doing.

When a doctor suspects vaginismus, they’ll generally perform the exam as gently as they can.

They may suggest that you help guide their hand or medical instruments into your vagina to make penetration easier. You can ask your doctor to explain every step of the exam to you as they go along.

During the exam, your doctor will look for any sign of infection or scarring.

In vaginismus, there’s no physical reason for the vaginal muscles to contract. That means, if you have vaginismus, your doctor won’t find another cause for your symptoms.

Treatment options for vaginismus

Vaginismus is a treatable disorder. Treatment usually includes education, counseling, and exercises.

  1. Sex therapy and counseling

Education typically involves learning about your anatomy and what happens during sexual arousal and intercourse. You’ll get information about the muscles involved in vaginismus, too. This can help you understand how the parts of the body work and how your body is responding.

Counseling may involve you alone or with your partner. Working with a counselor who specializes in sexual disorders may be helpful.

Relaxation techniques and hypnosis may also promote relaxation and help you feel more comfortable with intercourse.

  1. Vaginal dilators

Your doctor or counselor may recommend learning to use vaginal dilators under the supervision of a professional.

Place the cone-shaped dilators in your vagina. The dilators will get progressively bigger. This helps the vaginal muscles stretch and become flexible.

To increase intimacy, have your partner help you insert the dilators. After completing the course of treatment with a set of dilators, you and your partner can try to have intercourse again.

  1. Physical therapy

If you have a hard time using dilators on your own, obtain a referral to a physical therapist who specializes in the pelvic floor.

They can help you:

  • Learn more on how to use dilators
  • Learn about deep relaxation techniques

Sexual dysfunction can take a toll on relationships. Being proactive and getting treatment can be crucial in saving a marriage or relationship. It’s important to remember that there’s nothing to be ashamed of. 

Talking with your partner about your feelings and fears about intercourse may help you feel more relaxed. Your doctor or therapist can provide you with ways to overcome vaginismus. Many people recover and go on to live happy sexual lives. Scheduling treatment sessions with a sex therapist may be beneficial. Using lubrication or certain sexual positions can help make sexual intercourse more comfortable. If a woman finds intercourse painful, she should seek medical evaluation right away. When pain continues to be endured as part of sex, it increases the risk of conditioning a vaginismus response.

All material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns. We wish you all the best in your treatment and a happy sex life. It shall be well and healthy again.