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What is Vaginismus?

Vaginismus is a condition marked by involuntary contractions of the pelvic floor muscles that surround the vagina. These involuntary muscle spasms can range from mildly uncomfortable to severely painful.  Vaginismus can affect activities like being able to insert a tampon, having a doctor do a pelvic exam, or having sexual intercourse. It is important to remember that a woman does not purposely control or will the tightness to occur; it happens involuntarily, much to the confusion, frustration and disappointment of the woman and her partner.

What causes Vaginismus?

This condition is considered a sexual dysfunction associated with emotions, past memories or specific anxieties relating to vaginal penetration. While it can be related to a history of sexual abuse or trauma, it can occur in women with no such history or experience.  Vaginismus can happen at any point in one's life. Some women have never been able to have pain-free intercourse due to the spasms. This is considered primary vaginismus. Other women develop vaginismus after many years of pleasurable intercourse. This secondary type of vaginismus is usually triggered by childbirth, surgery, trauma or menopause.

Vaginismus can be situational, meaning some women cannot have sexual intercourse, but they can insert a tampon and may, or may not, be able to complete a pelvic exam. Although frustrating and often sexually devastating, vaginismus is treatable without the use of drugs or surgery.

What are some of the treatments for Vaginismus?

Effective treatment approaches combine pelvic floor control exercises (Kegel exercises), insertion or dilation training (Progressive Desensitization), pain elimination techniques, and exercises designed to help women identify, express and resolve any underlying emotional issues.

Kegel exercises

Kegel exercises allow a woman to identify, selectively control, exercise and retrain the pelvic muscles to reduce pain and tightness upon attempted penetration.

To perform Kegel exercises:

  • Contract the pelvic floor muscles
  • Hold for two seconds
  • Relax

It is advisable to practice doing 20 contractions at a time. Kegel exercises can be done as often as one thinks to do them. After a few days, the exercises can be repeated by inserting one’s fingers into the vagina, starting with one finger and working up to three. Short fingernails and lubricant are highly recommended. Fingers must be inserted at least 5-6 cm so one can feel the pelvic muscles contracting. Using one’s partner’s fingers is discouraged in treating vaginismus because it is counterproductive to associate one’s partner with pain.

Dilators

Progressive desensitization is a technique that uses vaginal dilators or Kegel balls to teach women how to override involuntary contractions so the pelvic floor can relax and respond correctly to sexual penetration. The dilators and Kegel balls come in graduated sizes so a woman can comfortably transition to the stage where she is ready for intercourse without pain or discomfort. Although it is advisable to use a lubricant when inserting dilators or Kegel balls, it is important to note that for many women lubrication, or for that matter arousal, was never the issue to begin with.

Therapy

Also, psychotherapy, talk therapy, sex therapy, EMDR (Eye Movement Desensitization and Reprocessing), and EFT (Emotional Freedom Technique) are all viable approaches for helping to ease fear and anxiety about sex or sexual functioning as well as for releasing/reframing traumatic memories.  

Related Vaginismus Resources

Sexual Pain, Emotional Trauma and the Road to Healing

 

MedAmour — Solutions for Intimate Wellness