Vaginismus

Vaginismus is the term used to describe recurrent or persistent involuntary tightening of muscles around the vagina whenever penetration is attempted.

It can disrupt or completely stop your sex life, and can lead to distress, a loss of confidence and relationship problems. It may even prevent you starting a family.

The condition can also make gynaecological and pelvic examinations difficult or impossible.

The symptoms can vary from one woman to the next. Some women are unable to insert anything into their vagina because it closes up completely, while others can insert a tampon but are unable to have penetrative sex, and other women are able to have sex but find it very painful.

Read more about the symptoms of vaginismus.

When to seek medical help

See your GP or visit a sexual health clinic if you think you might have vaginismus. You may feel embarrassed about seeking help, but vaginismus is a common sexual problem that can get better with appropriate support and treatment.

If your GP or doctor suspects vaginismus, they may be able to refer you to a specialist who can treat the problem, such as a doctor with training in sexual medicine, a gynaecologist, or a sex therapist.

What causes vaginismus?

Many factors can play a part in the development of vaginismus, although it's not fully understood why the condition happens.

Factors can include:

thinking the vagina is too small
negative sexual thoughts (thinking sex will be painful and cause damage)
previous sexual abuse
damage to the vagina (for example, during childbirth or an episotomy)
painful conditions of the vagina and surrounding area, such as vulvodynia (see below)
painful first intercourse
relationship problems
fear of pregnancy

Vulvodynia is the term used to describe the sensation of vulval burning, soreness or pain in the absence of any obvious skin condition or infection. Symptoms may be constant (unprovoked vulvodynia) or only occur with touch, inserting a tampon or penetrative sex (provoked vulvodynia).

Provoked vulvodynia can lead to vaginismus.

Read more about the causes of vaginismus.

How vaginismus is treated

Vaginismus can be treated. How it's treated will depend on the cause.

If there's an obvious physical cause, such as an infection, it can be treated with appropriate medication.

If the cause is psychological, sex therapy may be recommended. This may include counselling, brief dynamic psychoanalysis, or cognitive behavioural therapy (CBT), as well as treatments such as vaginal trainers and relaxation techniques.

Vaginal trainers are smooth, cylindrical dome-tipped shapes, usually made of plastic and in four graduated sizes that allow gentle progression of treatment. They can be used at home to help you get used to having something inserted into your vagina.