Vaginismus - Causes of vaginismus

There are many reasons why the vaginal muscles tighten against a woman's will. But it isn't always clear each time why this might have happened.

Sexual issues

Vaginismus is often associated with past sexual experiences or other sexual issues.

For example, an unpleasant experience at a young age, such as a clumsy, painful sexual encounter or gynaecological examination, can make the body respond in a protective way to prevent further pain.

Having difficulty understanding sex, or having feelings of shame or guilt around sex, could also contribute to vaginismus. For example, you might feel uncomfortable with sex if you:

• have had a very strict upbringing where it was never discussed
• have been told that sexual desire is wrong or that sex is painful
• are affected by cultural or religious taboos around sex 

Sexual abuse, assault or rape may also sometimes lead to vaginismus. Read more about getting help after a rape or sexual assault and recognising the signs of domestic violence.

Pain during sex

Experiencing pain during sex (dyspareunia) can contribute to vaginismus.

The following may all cause painful sexual intercourse:

• provoked vulvodynia (vestibulodynia) – oversensitive nerves at the opening of the vagina
• previous surgery to the genital area – such as an episiotomy during childbirth
• an infection of the genital area – such as candidiasis (thrush), genital herpes, or trichomoniasis, which is a sexually transmitted infection (STI) caused by a parasite
• radiotherapy to the pelvic area
• vaginal dryness – which can sometimes occur when taking the oral contraceptive pill or after the menopause 
• lack of sexual arousal 
• side effects of some medicines
• small tears at the opening to the vagina  

Endometriosis and pelvic inflammatory disease (PID) can also cause pain during sex, although the pain tends to be felt deeper within the pelvis.

Other causes

Other possible causes of vaginismus may include:

• fear that your vagina is too small for sexual intercourse
• fear of getting pregnant
• damage to the vagina and surrounding muscles during childbirth
• relationship problems
• tiredness or depression