What is vaginismus and how do you treat it?

What is it?

Vaginismus occurs when the muscles of the vagina tense and contract involuntarily, meaning that the vagina-owner is unable to control when this happens or how to stop the issue, often despite wanting to overcome it. The muscles of the vagina, which connects the uterus to the outside of the body, often contract due to penetration, either by a tampon, finger, penis or medical instrument. People with vaginismus can experience pain ranging from discomfort to severe spasms. 

How common is it?

Because vaginismus is rarely spoken about, doctors and scientists are unsure of how common it is. However, it is thought to be one of the most common female psychosexual dysfunctions there is, with an estimated 5-17% of vagina-owners being sufferers. However, other studies have found that these rates vary drastically, such as a study in 2019 which found that 60% of female patients to a sexual health clinic had vaginismus. 

What are the symptoms?

Vaginismus can begin from a very young age and is often discovered when a woman tries to insert something, commonly a tampon, into their vagina for the first time. The problem often then gets worse over time and is termed ‘primary vaginismus’.

Other vagina-owners can discover the issue much later on despite not experiencing pain before, called ‘secondary vaginismus’.

The pain a woman can experience ranges from mild to moderate to severe. Sufferers often describe it as feeling like something hits a brick wall. If you think you might suffer from vaginismus too, the symptoms can include:

• Pain and/or discomfort during vaginal penetration

• Pain during vaginal intercourse

• The inability to have vaginal intercourse or a vaginal examination due to spasms or pain in the vagina

What causes it?

Just as scientists are unsure about how common vaginismus is, the causes are also complicated. Sex, like many other medical health issues, ties closely to underlying psychological problems and these particularly are hard to separate from each other. There is often no obvious cause, but sufferers of primary vaginismus can develop the issue because of:

• fear or anxiety: about sex, sexually transmitted infections, pain or pregnancy pain. Vaginismus can also develop because of more generalised anxiety or other anxiety disorders

• taboos: religious or cultural taboos around sex, or a person’s inner conflict about whether to have sex or not

• unaroused sex: having sex when you don’t really want to

• history of abuse: a history of physical, emotional or sexual trauma and/or abuse

• feeling ‘not good enough’: a fear of not being good enough can lead to vaginismus

Sufferers of secondary vaginismus can also develop the issue because of the above, but often other issues can also lead to women developing it, such as:

• problems in relationships: these can lead to a lack of libido or arousal

• infections or skin problems: vaginal infections, such as thrush and vulval dermatological can sometimes cause vaginismus

• gynaecological problems: such as endometriosis, gynaecological cancer or breast cancer, or pelvic surgery can lead to women developing vaginismus

• pregnancy: vaginismus can occur after pregnancy, giving birth or being a new parent.

How can vaginismus affect you?

The effects of vaginismus for a sufferer are wide and far-reaching, often affecting every element of a woman’s life. Alongside pain inserting anything into a vagina, making sex or dealing with periods uncomfortable and stressful, women who suffer vaginismus often become depressed or anxious very quickly, seeing as the condition’s effect on a woman’s self-esteem is huge.

Some sufferers often avoid sex and sexual encounters for fear of the pain, whilst some also then end up avoiding being intimate at all in order to avoid all risk of it leading to penetration. This has a significant impact on relationships, resulting in distance and breakdown. It can also mean that single women avoid dating or finding a relationship.

Because vaginismus is not spoken about enough, women who suffer it can often feel embarrassed, in the dark or ‘abnormal’, avoiding speaking about the issue and unsure how to cope with it.

How do I treat it?

First things first, if you think you might have vaginismus or experience pain when inserting anything, however small, into your vagina, contact a doctor or your local GP.

Vaginismus is usually diagnosed after taking a long look at your medical history and figuring out what factors may cause it. Medical professionals who diagnose you are always incredibly gentle and are trained to do so in an empowering and relaxed way, meaning that you shouldn’t feel nervous before your first appointment.

It’s important to know that vaginismus is treatable and can be overcome by a programme of scheduled and effective methods. Doctors will talk to women who suffer with vaginismus about what causes vaginismus and the science behind the condition, so that they better understand it. Depending on the causes behind the condition, treatment can include medical management of any underlying physical conditions, psychological management or pelvic floor physiotherapy, which helps women learn how to relax both generally and in their pelvic muscles. It can often also help if women learn more about what pleasure during sex feels like and how to achieve it.

Vaginismus can be treated and if you think you may suffer, please contact your GP and stop any activity which is uncomfortable or painful. It’s important not to worry too much and to seek guidance sooner rather than later. It’s also very important that we start talking about vaginismus more, a lesser known female health problem that can affect a woman’s life in numerous ways.