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Vaginismus is a condition which inhibits or prevents a woman from engaging in vaginal penetration, either sexual intercourse, use of tampons or the penetration necessary for a gynecological examination. It is a spasm or a reflex rather like the automatic response which occurs when one’s hand touches a hot object and the arm flings itself away without any thought process involved.

It is a serious condition as it makes sexual techniques and sexual intercourse extremely painful or even impossible.

What is Vaginismus?

Therapists classify vaginismus into two categories, ‘Primary vaginismus’ and ‘Secondary vaginismus’. A woman with primary vaginismus has never been able to experience penetrative sex or undergo vaginal penetration without substantial pain. Secondary vaginismus is when a woman who has previously had no problems with penetration develops the condition.

Each condition has a separate cause and requires a different form of treatment. It is important to note that minor pain during penetrative sex is not vaginismus. Minor pain can be dealt with by the use of foreplay to heighten the woman’s sexual response.

Primary vaginismus

This is the condition where a woman has never been able to have penetrative sex or experience vaginal penetration without pain. It is usually discovered when a girl is in her teens, this being the time when young women attempt to use tampons, have penetrative sex, or undergo a Pap smear.

A woman with vaginismus will be unaware of the condition until she attempts vaginal penetration and when she does find out, she may not realize the consequences. She could believe that vaginal penetration should naturally be painless, or may not know of the condition. There are many causes of Primary vaginismus. They are the main ones.

  • A condition known as ‘vaginal vestibular syndrome’, in which the vulva, or area surrounding the vaginal opening, becomes inflamed and irritated, due to persistent infections.
  • Urinary tract infections or infections of the kidney or bladder.
  • Vaginal yeast infections. We advise all women who think they may have a vaginal infection to get treatment. We believe this is a great source of information. It explains yeast infection home remedy solutions which you can safely use for vaginal yeast infection.
  • Sexual abuse or attempted sexual abuse or rape or physically invasive trauma.
  • The witnessing of sexual or physical abuse of another, without being personally involved.
  • Domestic violence in the early stages of life.
  • Having been brought up to believe that sex is immoral, vulgar, or disgusting, or possibly having been told about sexual matters in an inappropriate fashion, before the age at which one can comfortably cope with such information.
  • General anxiety or stress or idiopathic, that is arising spontaneously or from an obscure or unknown cause.

Symptoms of vaginismus

There are various degrees of severity of the condition and not all sufferers experience all of the symptoms. These are some of the symptoms of the condition.

The most common symptom is where the patient has spasms of the pelvic floor or throughout the pelvis. This is an automated response that is the patient has no control over the situation. It often happens that when a patient is being examined, she will elevate the buttocks and close the thighs tightly to avoid examination.

Another symptom is a reaction such as sweating, hyperventilation, palpitations, trembling, shaking, or nausea, when sex or an examination is imminent. The most obvious symptom is an automated response where the pubococcygeus muscle closes the entry to the vagina making entry impossible. This reaction is comparable to erecting a barrier within the vagina blocking all access.

Secondary vaginismus

Secondary vaginismus is when a woman who has previously had no problems with penetration develops the condition. This can be due to physical causes such as trauma in childbirth or a disease like yeast infection, or it may be due to psychological causes. The treatment for secondary vaginismus is identical to that of primary vaginismus, but as successful penetration happened beforehand, successful treatment will probably be quicker.


Although vaginismus will not necessarily become more severe if left untreated, treatments are available and should be sought out. As there are many causes that can contribute to vaginismus, the form and variety of treatment can vary widely. As no two cases are the same, an individualized approach to treatment is required. Here are some of the many treatments available.

One treatment is vaginal probes, which are tapered blunt ended cylindrical objects. They come in different sizes but are normally the length and diameter of a tampon. The sufferer works with the therapist in an organized program where she slowly and gradually uses the probes to overcome her fear of penetration. It is usual for the woman to work the devices herself but, depending on the circumstances, the therapist can assist.

This procedure requires a great deal of trust on the part of the patient and also a lot of patience and understanding from the therapist. If these come together, with a lot of patience, a successful outcome usually occurs.

If the condition is psychosomatic, then a psychological treatment is called for. Studies show that the three most common contributing factors to vaginismus are fear of painful sex, the wrongful belief that sex is shameful or immoral and traumatic childhood sexual experiences. In this case the therapist or psychiatrist will work on the patient’s negative attitudes about her sexuality and the emotional difficulties involved.

The issues addressed may include low self-esteem, relationship problems, depression and psychological fear of penetration.

It should also be noted that there are many reasons why discomfort during sexual intercourse might lead to a problem with vaginismus, simply because of the association of sexual intercourse and physical discomfort. These conditions include hiatal hernia, acid reflux, heartburn, arthritis and several others. If you fall into this category, then it is essential that you seek good quality medical attention to alleviate the pain.

Another form of treatment for internal spasms is the use of vaginal dilators, which explore the vagina and desensitize the uncomfortable areas. These articles are small phallic shaped objects used by the therapist. The treatment can be uncomfortable and therefore is spread over several sessions but a successful outcome is usually the result.

The latest form of treatment is the chemical, Botox, a substance usually associated with rejuvenated faces. It is used when the patient is too emotional or fearful to take on the probes or dilators. This option relaxes the muscle spasm for a short period, usually about three months. During this time the relaxation offered by the Botox, will enable the patient to come to terms with either natural vaginal intercourse or the use of probes or dilators.

What I would like to stress is that vaginismus is a common problem but sadly many women do not seek out a treatment. My message to these women is: The condition is treatable. See your doctor who will be able to offer you the proper diagnosis and treatment!


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