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VAGINISMUS

VAGINISMUS

What is Vaginismus?

Vaginismus is vaginal tightness causing discomfort, burning, pain, penetration problems, or complete inability to have intercourse.

Depending on the intensity, Vaginismus symptoms range from minor burning sensations with tightness to total closure of the vaginal opening with impossible penetration.

The vaginal tightness results from the involuntary tightening of the pelvic floor, especially the pubococcygeus (PC) muscle group, although the woman may not be aware that this is the cause of her penetration or pain difficulties.

Vaginismus is a common cause of ongoing sexual pain and is also the primary female cause of sexless (unconsummated) marriages. Sexual pain can affect women in all stages of life; even women who have had years of comfortable sex. While temporarily experiencing discomfort during sexual intercourse is not unusual, ongoing problems should be diagnosed and treated.

Common Symptoms of Vaginismus

  • Burning or stinging with tightness during sex
  • Difficult or impossible penetration, entry pain, uncomfortable insertion of penis
  • Unconsummated marriage
  • Ongoing sexual discomfort or pain following childbirth, yeast/urinary infections, STDs, IC, hysterectomy, cancer and surgeries, rape, menopause, or other issues
  • Ongoing sexual pain of unknown origin, with no apparent cause
  • Difficulty inserting tampons or undergoing a pelvic/gynaecological exam
  • Spasms in other body muscle groups (legs, lower back, etc.) and/or halted breathing during attempts at intercourse
  • Avoidance of sex due to pain and/or failure

Examples of the effects of Vaginismus

Left diagram – As the man approaches the woman to attempt intercourse, her PC muscle group (darkly shaded) involuntarily tightens the vaginal entrance making intercourse painfully impossible ‘like bumping into a wall’. This type of Vaginismus makes penetration impossible.

Right diagram – In other cases of Vaginismus, penetration may be possible, but the woman experiences periods of involuntary tightness causing burning, discomfort, or pain.

Vaginismus can be triggered in both younger and older women, in those with no sexual experience and those with years of experience. Not all women experience Vaginismus the same way, and the extensiveness of Vaginismus varies:

  • Some women are unable to insert anything at all.
  • Some women are able to insert a tampon and complete a gynaecological exam, yet are unable to insert a penis.
  • Others are able to partially insert a penis, although the process is very painful.
  • Some are able to fully insert a penis, but tightness and discomfort interrupt the normal progression from arousal through to orgasm and bring pain instead.
  • Some women are able to tolerate years of uncomfortable intercourse with gradually increasing pain and discomfort that eventually interrupts the sexual experience.

Women may also experience years of intermittent difficulty with entry or movement and have to constantly be on their guard to control and relax their pelvic area when it suddenly ‘acts up’.

Vaginismus Symptom Severity Range

  1. Minor discomfort or burning with tightness is experienced with vaginal entry or thrusting but may diminish.
  2. More significant burning and tightness is experienced with vaginal entry or thrusting and tends to persist.
  3. Involuntary tightness of the vaginal muscles makes entry and movement difficult and painful.
  4. Partner is unable to penetrate due to tightly closed vaginal opening. If entry is forced significant pain results.

How does Vaginismus cause problems?

With Vaginismus, the mind and body have developed a conditioned response against penetration. The body has learned to expect or anticipate pain upon penetration, so that the powerful PC muscle ‘flinches’ or contracts to protect against the potential of intercourse pain. This can be equated to automatically blinking one’s eyes and wincing when an object is hurled toward us. It is not something a woman thinks about doing – it just happens (see Causes).

The tightened PC muscles may cause burning or pain with sex or may completely block entry. Instead of preventing pain, the tightening of the PC muscle group ultimately causes pain; although acting as a defence mechanism against pain, the opposite effect results.

Vaginismus has a wide range of manifestations, from impossible penetration, to intercourse with discomfort, pain or burning, all resulting from involuntary pelvic tightness. When a woman has never been able to have pain-free sexual intercourse due to penetration difficulties, it is generally classified as primary Vaginismus. When a woman develops the Vaginismus condition after having previously enjoyed problem-free sex, it is generally classified as secondary Vaginismus. Depending upon the classification, there may be some minor differences in the way in which Vaginismus is treated.

Primary Vaginismus

When a woman has never at any time been able to have pain-free intercourse due to Vaginismus tightness, her condition is known as primary Vaginismus.

Primary Vaginismus refers to the experience of Vaginismus with ‘first-time’ intercourse attempts. Typically, primary Vaginismus will be discovered when a woman attempts to have sex for the very first time. The spouse/partner is unable to achieve penetration and it is like he just bumps into a ‘wall’ where there should be the opening to the vagina. Entry is impossible or extremely difficult. Primary Vaginismus is the common cause of sexless, unconsummated marriages. Some women with primary Vaginismus will also experience problems with tampon insertion or gynaecological exams. The PC muscles constrict and tighten the vaginal opening making it uncomfortable or in many cases virtually impossible to have entry. When tightened, attempts to insert anything into the vagina produce pain or discomfort.

Some women also experience related spasms in other body muscle groups or even halted breathing. Generally, when the attempt to put something in the vagina has ended, the muscles relax and return to normal. For this reason, medical examinations often fail to reveal any apparent problems unless the tightness occurs and is noted during the pelvic exam.

Vaginismus Risk Factors

Vaginismus can strike any woman at any time at any age. Contributing factors could include:

  • Pelvic pain due to a medical condition, infection, physical trauma or assault, age-related changes, or painful physical events such as childbirth.
  • Emotional distress, anxiety, fear, relational difficulties, or other similar emotions that relate to sex, intimacy, past trauma, or relationships.
  • The anticipation pelvic pain due to some past or present condition or situation.
  • Other causes.

Secondary Vaginismus sexual pain can affect women in all stages of life, even women who have had many years of pain-free intercourse.

Secondary Vaginismus refers to the experience of tightness pain or penetration difficulties later in life, after previously being able to have normal, pain-free intercourse. It typically follows or is triggered by temporary pelvic pain or other related problems. It can be triggered by medical conditions, traumatic events, relationship issues, surgery, life-changes (e.g. menopause), or for no apparent reason. Secondary Vaginismus is the common culprit where there is continued, ongoing sexual pain or penetration tightness where there had been no problem before.

Most commonly, secondary Vaginismus strikes women experiencing temporary pelvic pain problems such as urinary or yeast infections, pain from delivering babies, menopause, or surgery. The initial pain problems are addressed medically, healed, and/or managed, yet women continue to experience ongoing sexual pain or penetration difficulties due to Vaginismus. While the initial temporary pain was experienced, their bodies developed a conditioned response resulting in ongoing, involuntary vaginal tightness with attempts at intercourse.

Left untreated, Vaginismus often worsens, because the experience of ongoing sexual pain further increases the duration and intensity of the involuntary PC muscle contraction. The severity of secondary Vaginismus may escalate so that sex or even penetration is no longer possible without great difficulty. Some women will also experience difficulty with gynaecological exams or tampon insertion. Vaginismus can also impede a woman’s ability to experience orgasm during intercourse, as any sudden pangs of pain will abruptly terminate the arousal build-up toward orgasm.

Vaginismus is involuntary – not intentional

It is important to note that Vaginismus is not triggered deliberately or intentionally by women. It happens involuntarily without their intentional control and often without any awareness on their part. Vaginismus has a variety of causes, often in response to a combination of physical or emotional factors. The mystery of the problem can be very frustrating and distressing for both women and their partners. Despite the fact that Vaginismus is involuntary and can strike any woman, many women feel intense shame from being unable to have intercourse and keep their pain private, feeling uncomfortable sharing their secret with anyone.

“It always felt tight and uncomfortable. I never realized it was Vaginismus.”
“I’m still a virgin even though we’ve tried many times – it’s like he hits a wall.”
“Sex was fine until after the baby – now it always hurts.”
“The doctor says there’s nothing wrong with me. So why does it still hurt?”
“Ever since the operation I feel burning pain when I try to get him in.”
“I don’t wear tampons because it is too hard to get them in.”
“There’s no way I’m doing a pelvic exam again – it’s unbearable.”
“I experience burning pain upon penetration attempts.”
“Sex used to be great, but now I close up – it burns and stings.”
“We can’t consummate our marriage – it’s impossible.”
“When he starts to move, it feels uncomfortable and we have to stop.”
“After menopause I began to feel soreness and now I tighten up.”
“I seem to ‘tighten’ up down there even when I really want to have sex.”
“Sex has never been comfortable for me.”

Unconsummated Marriages & Impossible Penetration

With severe cases of Vaginismus where there has never been penetration, is it really possible to overcome? Is there hope for unconsummated couples?

Yes. Fortunately Vaginismus is highly treatable with full restoration of sexual intercourse. Couples completing treatment fully consummate and enjoy normal penetrative sex.

Vaginismus is by far the most common cause of unconsummated marriages (where the problem is due to female issues). Couples often describe their attempts at intercourse as there being a “wall” where the vaginal opening should be. It is baffling to some women as to how this condition originated in them if they had no prior sexual contact or pelvic problems. Intercourse is impossible and painful insertion attempts reinforce the Vaginismus response. The conditioned reflex continues to happen every time there is potential for vaginal penetration. The muscles act rebelliously, refusing to allow entry even though the woman may truly want to consummate and receive her spouse vaginally. This is extremely frustrating. For the aroused man, it is like running into a brick wall. For the woman, it is like her body is no longer under her control.

Sex is an activity involving many complex conditioned responses. Bodies do not start out as skilled reactors to sexual stimulus. Successful intercourse is learned through experience and interaction. The nervous system and musculature discover and remember what feels good, works, and what isn’t comfortable. Normally, the transition to intercourse becomes more pleasurable after the first few experiences. The mind and body allow entry and learn to anticipate intercourse positively. Healthy messages result and they generate arousal in anticipation of intercourse. In a woman with primary Vaginismus, the mind and body never get the chance to be trained through positive intercourse experiences. The process of learning how to have successful intercourse is cut short when the vaginal muscles spasm as a protective device against pain. With the absence of any direct conscious control on the woman’s part, nerves controlling the vaginal muscles react to the anticipation of intercourse as a call to tightly constrict, brace, protect, and guard against the onset of potential penetration pain.

What Causes Vaginismus?

Vaginismus is a unique condition in that it may result from a combination of either physical or non-physical causes or it may seem to have no cause at all.

For many women, Vaginismus comes as a surprise; unexplained tightness, discomfort, pain, and entry problems are unexpectedly experienced during intercourse attempts. The pain results from the tightening of the muscles around the vagina (PC muscles). Since this occurs without the conscious intent or control of the woman, it can be very perplexing.

Usually at the root of Vaginismus is a combination of physical or non-physical triggers that cause the body to anticipate pain. Reacting to the anticipation of pain, the body automatically tightens the vaginal muscles, bracing to protect itself from harm. Sex becomes uncomfortable or painful, and entry may be more difficult or impossible depending upon the severity of this tightened state. With attempts at sex, any resulting discomfort further reinforces the reflex response so that it intensifies more. The body experiences increased pain and reacts by bracing more on an ongoing basis, further entrenching this response and creating a Vaginismus ‘cycle of pain’.

Examples of Non-physical Causes:

Fears: Fear or anticipation of intercourse pain, fear of not being completely physically healed following pelvic trauma, fear of tissue damage (ie. “being torn”), fear of getting pregnant, concern that a pelvic medical problem may reoccur, etc.
Anxiety or stress: General anxiety, performance pressures, previous unpleasant sexual experiences, negativity toward sex, guilt, emotional traumas, or other unhealthy sexual emotions.
Partner issues: Abuse, emotional detachment, fear of commitment, distrust, anxiety about being vulnerable, losing control, etc.
Traumatic events: Past emotional/sexual abuse, witness of violence or abuse, repressed memories.
Childhood experiences: Overly rigid parenting, unbalanced religious teaching (ie.”Sex is BAD”), exposure to shocking sexual imagery, inadequate sex education.
No cause: Sometimes there is no identifiable cause (physical or non-physical).

Addressing Vaginismus Causes

Vaginismus does not always have an obvious cause. Sometimes women with near perfect childhoods, great relationships, strong education, and few anxieties, have trouble finding any plausible explanation for what caused their Vaginismus. Understanding why they had Vaginismus may remain a mystery even after it is fully resolved. Fortunately, though it is helpful to know the causes, full knowledge is not necessary to complete successful treatment.

Examples of Physical Causes:

Medical conditions: Urinary tract infections or urination problems, yeast infections, sexually transmitted disease, endometriosis, genital or pelvic tumors, cysts, cancer, vulvodynia / vestibulodynia, pelvic inflammatory disease, lichen planus, lichen sclerosus, eczema, psoriasis, vaginal prolapse, etc.
Childbirth: Pain from normal or difficult vaginal deliveries and complications, c-sections, miscarriages, etc.
Age-related changes: Menopause and hormonal changes, vaginal dryness / inadequate lubrication, vaginal atrophy.
Temporary discomfort: Temporary pain or discomfort resulting from insufficient foreplay, inadequate vaginal lubrication, etc.
Pelvic trauma: Any type of pelvic surgery, difficult pelvic examinations, or other pelvic trauma.
Abuse: Physical attack, rape, sexual/physical abuse or assault.
Medications: Side-effects may cause pelvic pain.

Since Vaginismus can be triggered by physical events as simple as having inadequate foreplay or lubrication, or non-physical emotions as simple as general anxiety, it is important that it be understood that Vaginismus is not the woman’s fault. Once triggered, the involuntary muscle tightness occurs without conscious direction; the woman has not intentionally ’caused’ or directed her body to tighten and cannot simply make it stop. Women with Vaginismus may initially be sexually responsive and deeply desire to make love but over time this desire may diminish due to pain and feelings of failure and discouragement. It is extremely frustrating to be unable to physically engage in pleasurable sexual intercourse.

Why do these causes trigger Vaginismus in some women but not in others?

Life experiences vary dramatically from person to person. Some women’s bodies react with Vaginismus, while others with nearly identical experiences do not.

The anticipation of pain, emotional anxieties, or unhealthy sexual messages can contribute to and reinforce the symptoms of Vaginismus. Frequently, but not always, there are deep-seated underlying negative feelings of anxiety associated with vaginal penetration. Emotional triggers that result in Vaginismus symptoms are not always readily apparent and require some exploration. It is important that effective treatment processes include addressing any emotional triggers so a full pain-free and pleasurable sexual relationship can be enjoyed upon resolution.

Vaginismus is often a complicating factor in the recovery from other pelvic pain conditions. Vaginismus may co-exist with other medical conditions, possibly triggered by temporary pelvic pain resulting from those conditions. Or, it can be the sole cause of sexual pain remaining after the original medical problems are addressed. When the underlying cause has been resolved or managed and ongoing pain, discomfort or penetration difficulties continue to remain, this is typically due to Vaginismus.

In cases where there is clearly both Vaginismus and another pelvic medical problem existing simultaneously, both problems will need to be treated to ensure full resolution. Without addressing the other medical condition, it will be difficult to resolve the Vaginismus as it may continue to be triggered by pain from the other problem.

The Role of the PC muscle group

How it contributes to sexual pain or penetration problems

The pelvic floor muscles predominant in Vaginismus are called the pubococcygeus (PC) muscle group. The PC muscle group plays a key role in the function of a woman’s reproductive system, urinary tract, and bowels. The muscles enable a woman to urinate, have intercourse, orgasm, complete bowel movements, and deliver babies. Hence, they are also referred to as pelvic floor muscles, vaginal muscles, and love muscles.

With Vaginismus, the mind and body have developed a muscle memory or conditioned response against penetration. The body has learned to expect or anticipate pain upon penetration, so that the powerful PC muscle ‘flinches’ or contracts to protect against the potential of intercourse pain. This can be equated to automatically blinking one’s eyes and wincing when an object is hurled toward us. It is not something a woman thinks about doing – it just happens. Unfortunately, instead of preventing pain, the tightening of the PC muscle group ultimately causes pain; although acting as a defence mechanism against pain, the opposite effect results. The spasms cause burning or pain upon penetration or movement and may even completely block entry.

The PC muscle group is large and very powerful. It encircles the urinary opening, vagina, and anus in a figure-eight pattern with one loop of muscles surrounding the vaginal area and the other loop surrounding the anal area. On each end, the muscles are attached to the skeleton and support and hold in place the abdominal and pelvic organs like a net, forming the pelvic floor.

PC Muscles – The anatomy of the female pelvic floor area highlights the internal muscles called the pubococcygeus or PC muscle group. This is the muscle group that tightens involuntarily when Vaginismus is experienced. The powerful muscle group surrounds both the entire vaginal area and the anus area.

Never fully relaxed, but always partially contracted, the PC muscles are ready to spring into action the moment they sense the need, powerfully tightening even without the woman’s awareness. For example, they enable a woman to retain urine or control her bowel movements until a convenient time without her thinking about it. In Vaginismus, during attempted penetration, the PC muscles tighten involuntarily, without conscious intent (thought), and constrict the vaginal opening. This tightening is what makes intercourse uncomfortable, painful, or unachievable. The pain is often experienced without any awareness of the cause. Frustration is often common as a woman knows that there is something wrong, but is unaware her problem is Vaginismus and treatment is available.

Retraining the Body

Retraining the PC muscle group to respond differently to the anticipation of intercourse is key to the successful treatment of Vaginismus. The process of learning to take conscious control of this muscle group changes the conditioned reflex so involuntary tightness no longer occurs (modifying the muscle memories or conditioned responses). Effective program steps will comprehensively address both body and mind components to resolve all triggers so that when intercourse is attempted involuntary spasms no longer occur and pain is eliminated.

Vaginismus Diagnosis & Tests

Women often suspect they have Vaginismus from their symptoms. Medical diagnosis is typically determined by gynaecological exam to rule out the possibility of other conditions and patient history.

Quick diagnosis chart – common manifestations of Vaginismus

Strong indicators of Vaginismus include any of the following:

·       Difficult penetration or impossible intercourse / unconsummated couples

Female penetration problems and unconsummated marriages are typically due to Vaginismus. Entry tightness and pain are common symptoms of Vaginismus.

·       Ongoing sexual pain after a pelvic problem, medical issue, or surgery

The experience of ongoing sexual pain or tightness after resolving or managing a pelvic medical or pain issue is typically due to Vaginismus (see also dyspareunia).

·       Ongoing sexual pain after childbirth

The experience of ongoing sexual pain or tightness following childbirth (after everything has healed) is typically due to secondary Vaginismus.

·       Ongoing sexual pain and tightness with no discernible physical cause

Vaginismus often occurs only during sex attempts. Physicians may initially be unable to find any problem or cause for the sexual difficulties.

·       Avoidance of sex due to pain and/or failure

When a woman states that she avoids being intimate with her husband because sex does not feel good or has become very painful, Vaginismus should be strongly considered.

Is there a simple medical test I can take that would tell me if I have Vaginismus?

There is no medical test that can be taken to confirm the Vaginismus condition. Vaginismus is diagnosed through patient history and description of problem/pain, and gynaecological examination to rule out the possibility of other conditions.

The medical diagnosis of Vaginismus

Women often suspect they have Vaginismus from their symptoms, but getting medical confirmation can be challenging. Confirming a formal diagnosis of Vaginismus may take some planning and perseverance. No definitive medical test exists for the diagnosis of Vaginismus so it may take a number of visits to several physicians or specialists before a medical diagnosis is obtained. When physicians are initially unable to find any specific medical problem (a common experience of Vaginismus sufferers), no diagnosis or misdiagnosis is a common outcome of initial medical exams. Many physicians are unfamiliar with Vaginismus, so part of the process is simply finding a physician that is knowledgeable about the condition. A successful medical diagnosis of Vaginismus is typically determined through patient history and description of the problem, gynaecological examination and the process of ruling out the possibility of other conditions.

Talking to physicians about sexual problems can be difficult. Embarrassment, shame and anxiety are often present, making it hard to communicate and obtain appropriate care. Women may need to strongly advocate for themselves, insisting on a full diagnosis from a knowledgeable professional to rule out any other medical condition and properly confirm the Vaginismus diagnosis. A medical diagnosis is helpful in removing any doubts or anxiety related to identifying the condition and enables women to have more confidence in moving toward treatment solutions.

Sexual pain disorders like Vaginismus are commonly misdiagnosed or left unaddressed. Women may need to be very courageous in persevering until their concerns are given due attention and a reliable medical diagnosis is reached. In some cases and locations, a solid medical diagnosis is not always available or possible. This is especially true in nations with fewer health care options.

The pelvic exam as part of Vaginismus diagnosis

One of the most important aspects of Vaginismus diagnosis is simply the thorough elimination of other possible physical or medical conditions that may be causing the symptoms – leaving the near-certain likelihood of Vaginismus. The process of elimination is a critical part of Vaginismus diagnosis.

The diagnostic process will typically entail giving a medical and sexual history and undergoing a pelvic or gynaecological exam. The physician will discuss the location and occurrence of pain to help render an accurate Vaginismus diagnosis or may request some other tests to help rule out any other problems besides Vaginismus.

Note that some women feel more comfortable expressing themselves and being examined by female health care specialists. Where this is an issue, we encourage women to seek a referral with a female specialist. Taking a proactive, systematic approach will help a person get better care and treatment outcomes.

Burning, tightness, and difficult penetration symptoms may not be at all noticeable during the pelvic exam. For some women, these symptoms occur only during intercourse attempts. For this reason, diagnosis must involve serious consideration of the woman’s concerns which might be stated vaguely as “I’m having difficulty with sex.” Sometimes, busy health care professionals will fail to recognize the signs of Vaginismus and give standard (but unhelpful) advice to just “use more lubricant”, “try to relax more”, or “drink some wine”. This may be due to a lack of familiarity with Vaginismus or reliance on outdated literature on the condition.

Due to PC muscle tightness, some women with Vaginismus find gynaecological exams to be extremely painful and are unable to tolerate them. If a woman suspects she may have difficulty completing an exam, she should communicate this to her physician. There are adjustments (e.g. body positioning, size of speculum used, and nurse support) that can be made to contribute to a more positive experience. A physician who is familiar with the Vaginismus condition will be more suited to providing a comfortable and sensitive environment.

When there is constant vaginal tightness for the duration of the pelvic exam, it may appear to the physician as though there is an unusually small vagina or a hymen abnormality problem. Instead of recognizing the Vaginismus condition, a physician may falsely believe a woman’s vagina is too small, when/if she is unable to complete a pelvic exam (see diagram below). This combined with the patient’s urgent complaint that she cannot have penetrative sex with her spouse or that sex really hurts, may further lead to the false assumption that the vagina requires corrective surgery to enlarge the opening and allow entry. Though there may be rare exceptions, women with Vaginismus typically have completely normal genitalia. The constriction of the vagina is due solely to the tight involuntary spasm of the pelvic floor muscles. Unfortunately, some physicians continue to press forward with the pelvic exam causing great discomfort and pain for the woman. This traumatic experience in itself can contribute to the Vaginismus condition.

Figure showing constriction during pelvic exam – With Vaginismus, the simple approach of a physician’s hand may have the effect of tightening the pelvic floor muscles and making the vaginal entrance seem very small and tight. Note that not all women with Vaginismus will experience tightness during a medical exam (tightness may only occur during sex attempts).

There are many dangers in being given an improper diagnosis from an uninformed professional. Unnecessary, invasive and potentially harmful surgeries and medications have been suggested for women with Vaginismus who have not been properly diagnosed.

Misdiagnosis and the promotion of invasive or unhelpful surgeries are sometimes the unfortunate result of all this confusion. There is no surgery to cure Vaginismus. It is very important to seek a second opinion if surgery to ‘widen’ the vaginal opening has been recommended as this does not normally resolve the penetration problem, but instead may further complicate the problem. Unnecessary, invasive, and potentially harmful surgeries and medications have been suggested for women with Vaginismus who have not been properly diagnosed. Vaginismus is a highly treatable condition that does not require any invasive procedures.

Many women seeking diagnosis are often simply left undiagnosed and turned away by physicians who fail to find anything physically wrong and feel there is nothing more they can do. They may not consider a diagnosis of Vaginismus due to simple lack of awareness.

To assist women in obtaining reliable diagnosis for their sexual pain, the following sample script includes helpful tips to prepare for a physician visit. The script provides examples related to the Vaginismus condition, however, it can be easily modified to help communicate the details of any sexual or pelvic pain problem:

Sample Script: Self-Guided History of Sexual Pain

1. Introduce the problem:

“I have been having problems with pain during sex and hope you will be able to help me.”

2. Provide a description of the pain (be specific):

  • It happens when …”my husband tries insert his penis in my vagina” or “once he is inside and starts to move I feel burning and tighten up”, etc.
  • The pain is located …”at the entrance to my vagina. My vagina is like a wall; he just cannot get it in.” or “after he is inside I feel burning around the penis just inside the entrance”, etc.
  • The pain lasts …”as long as he keeps trying, especially if we try forcing it in. Once he stops there is no pain.”
  • This has been happening since …”our honeymoon two years ago and has continued to happen every time we try to have sex” (primary Vaginismus) or “my hysterectomy eight months ago”(secondary Vaginismus), etc. [Note: Inform your doctor if you have been able to previously have sexual intercourse without pain.]
  • It feels like …”burning”, “stinging”, “like he’s hitting a wall”, “tightness during/on entry”, etc.
  • I have tried to reduce or eliminate the pain by …”using lubricant, changing sexual positions, relaxing more.”
  • I am able / unable to …”insert a tampon or complete a gynaecological exam.”

3. Mention any past problems:

Have you previously had any sexually transmitted diseases, yeast infections, bladder problems, or any pelvic pain outside of penetration?

4. Mention any past sexual abuse.

5. State what you think the problem is:

“I think it may be Vaginismus. My symptoms are similar to those outlined in an article I read. However, I have read there are other things that can cause pain during sex and would like to have them ruled out.”

Vaginismus Treatment

Vaginismus is considered one of the most successfully treatable female sexual disorders. Many studies have shown treatment success rates approaching nearly 100%. Treatment resolution follows a manageable, step-by-step process.

Successful Vaginismus treatment does not usually require drugs, surgery, hypnosis, nor any other complex invasive technique. Effective treatment approaches combine pelvic floor control exercises, insertion or dilation training, pain elimination techniques, transition steps, and exercises designed to help women identify, express and resolve any contributing emotional components. Treatment steps can often be completed at home, allowing a woman to work at her own pace in privacy, or in cooperation with her health care provider.

  • The sexual pain, tightness and penetration difficulties from Vaginismus are fully treatable and can be completely overcome with no remaining pain or discomfort.
  • Women experiencing sexual tightness/pain, penetration problems, or unconsummated relationships can expect remarkable resolution of their Vaginismus, allowing full, pain-free intercourse.
  • Treatment steps can usually be completed at home using a self-help approach, allowing a woman to work at her own pace in privacy, or in cooperation with her health care provider or specialist.
  • Vaginismus treatment exercises follow a manageable, step-by-step process

The sexual pain, tightness, burning or penetration difficulties caused by Vaginismus are completely treatable, with high success rates for treatment. Couples are often amazed by the sudden life-changing effects of treatment. Those with penetration difficulties, or pain during intercourse, normally transition to pain-free and pleasurable intercourse following a step-by-step approach.

Vaginismus is considered one of the most successfully resolved female sexual disorders. High treatment success rates are typical within reasonable time frames.

Many of the steps to treat Vaginismus are counter-intuitive and not immediately obvious. As failure at any point inhibits recovery (experiencing discomfort tends to intensify Vaginismus) and can cause avoidance or abandonment of progress, it is best to approach Vaginismus with an educated understanding to ensure success in dealing with it.

Sources consulted: www.vaginismus.com