Vaginismus is a condition involving a muscle spasm in the pelvic floor muscles. It can make it painful, difficult, or impossible to have sexual intercourse, to undergo a gynecological exam, and to insert a tampon.
In vaginismus, vaginal muscles tighten involuntarily despite women’s desire for sexual intercourse. Vaginismus usually begins when women first attempt to have sexual intercourse. However, it sometimes develops later, for example, when another factor makes intercourse painful for the first time or when women attempt intercourse while they are emotionally distressed.
There are different types of vaginismus that can affect women at different ages.
- Primary vaginismus
This is a lifetime condition in which the pain has always been present. It will be difficult to use a tampon and to undergo a gynecological exam.
It is often experienced by women during their first attempt at intercourse. The male partner is unable to insert his penis into the vagina. He may describe a sensation like “hitting a wall” at the vaginal opening.
There may be pain, generalized muscle spasms, and the woman may temporarily stop breathing. The symptoms are reversed when the attempt at vaginal entry is stopped.
- Secondary vaginismus
This develops after a woman has already experienced normal sexual function. It has not always been present. It can occur at any stage of life, and it may not have happened before.
It usually stems from a specific event, such as an infection, menopause, a traumatic event, development of a medical condition, relationship issues, surgery, or childbirth.
Even after any underlying medical condition is corrected, pain can continue if the body has become conditioned to respond in this way.
- 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.
Painful sex is often a woman’s first sign that she has vaginismus. The pain happens only with penetration. It usually goes away after withdrawal, but not always. Although there is a believe that it is one of the major causes of penis captivus.
Women have described the pain as a tearing sensation or a feeling like the man is “hitting a wall.”
Many women who have vaginismus also feel discomfort when inserting a tampon or during a doctor’s internal pelvic exam.
Vaginismus is a condition which can be caused by physical stressors, emotional stressors, or both. It can become anticipatory, so that it happens because the person expects it to happen.
- fear, for example, of pain or pregnancy
- anxiety, about performance or because of guilt
- relationship problems, for example, having an abusive partner or feelings of vulnerability
- traumatic life events, including rape or a history of abuse
- childhood experiences, such as the portrayal of sex while growing up or exposure to sexual images
- infection, such as a urinary tract infection (UTI) or yeast infection
- health conditions, such as cancer or lichen sclerosis
- pelvic surgery
- inadequate foreplay
- insufficient vaginal lubrication
- medication side effects
Sexual problems can affect both men and women. They are not anyone’s fault, and they are nothing to be ashamed of.
In most cases, treatment can help.
Women with vaginismus can do exercises, in the privacy of their own home, to learn to control and relax the muscles around the vagina.
The approach is called progressive desensitization, and the idea is to get comfortable with insertion.
First, do Kegel exercises by squeezing the same muscles you use to stop the flow of urine when urinating:
- Squeeze the muscles.
- Hold for 2 to 10 seconds.
- Relax the muscles.
Do about 20 Kegels at a time. You can do them as many times a day as you want to.
After a few days, insert one finger, up to about the first knuckle joint, inside the vagina while doing the exercises. It’s a good idea to clip your fingernails first and use a lubricating jelly.
Start with one finger and work your way up to three. You’ll feel the vagina’s muscles contracting around your finger, and you can always take your finger out if you’re not comfortable.
If you have vaginismus and think it is related to fear or anxiety, you should see a therapist.