Vaginismus is classified into two types:

  • primary vaginismus: when vaginal penetration has never been achieved
  • secondary vaginismus: when vaginal penetration was once achieved, but is no longer possible or is painful.


Some women develop vaginismus after menopause. When oestrogen levels drop, a lack of vaginal lubrication and elasticity makes intercourse painful, stressful, or impossible. This can lead to vaginismus in some women.



Dyspareunia is the medical term for painful sexual intercourse. It’s often confused with vaginismus.

However, dyspareunia could be due to:

  • cysts
  • pelvic inflammatory disease
  • vaginal atrophy


Whereas there’s not always a reason for vaginismus. The condition has been linked to:

  • past sexual abuse or trauma
  • past painful intercourse
  • emotional factors

In some cases, no direct cause can be found.


Symptoms of vaginismus

Involuntary tightening of the vaginal muscles is the primary symptom of vaginismus, but the severity of the condition varies between women. In all cases, constriction of the vagina makes penetration difficult or impossible.

If you have vaginismus, you can’t manage or stop the contractions of your vaginal muscles. Vaginismus is often accompanied by additional symptoms, including fear of vaginal penetration and decreased sexual desire related to penetration.

Women with vaginismus often report a burning or stinging pain when anything is inserted into the vagina.

If you have vaginismus, it doesn’t mean that you’ll stop enjoying sexual activities altogether. Women who have the condition can still feel and crave sexual pleasure and have orgasms.

Many sexual activities don’t involve penetration, including:

  • oral sex
  • massage
  • masturbation

Diagnosis of vaginismus

Diagnosis of vaginismus usually begins with describing your symptoms to your doctor. Your doctor will likely ask:

  • when you first noticed a problem
  • how often it occurs
  • what seems to trigger it

Your doctor will usually ask about your sexual history, which may include questions about whether you’ve ever experienced sexual trauma or abuse.

In general, diagnosis and treatment of vaginismus require a pelvic exam.

It’s common for women with vaginismus to be nervous or fearful about pelvic exams. If your doctor recommends a pelvic exam, you can discuss ways to make the exam as comfortable as possible for you. You may feel more at ease if you can use a mirror to see what your doctor is doing.

If a doctor suspects vaginismus, they’ll generally perform the exam as gently as they can. They may suggest that you help guide their hand or medical instruments into your vagina to make penetration easier. You can ask your doctor to explain every step of the exam to you as they go along.

During the exam, your doctor will look for any sign of infection or scarring.

In vaginismus, there’s no physical reason for the vaginal muscles to contract. That means, if you have vaginismus, your doctor won’t find another cause for your symptoms.

Treatment options for vaginismus

Vaginismus is a treatable disorder. Treatment usually includes education, counselling, and exercises.


Sex therapy and counselling

Education typically involves learning about your anatomy and what happens during sexual arousal and intercourse. You’ll get information about the muscles involved in vaginismus, too. This can help you understand how the parts of the body work and how your body is responding.

Counseling may involve you alone or with your partner. Working with a counsellor who specialises in sexual disorders (sex therapist) may be particularly helpful.

Relaxation techniques may also promote relaxation and help you feel more comfortable with intercourse. Pelvic physiotherapists specialise in helping people with pelvic floor muscle issues.

Vaginal dilators

Your doctor or counsellor may recommend learning to use vaginal dilators under the supervision of a professional. It is not advised that you attempt to use vaginal dilators without direction and guidance from professionals.

The dilators will get progressively bigger as you progress through your therapy. This helps the vaginal muscles stretch and become flexible.

To increase intimacy, have your partner help you insert the dilators. After completing the course of treatment with a set of dilators, you and your partner can try to have intercourse again.

Physical therapy

If you have a hard time using dilators on your own, obtain a referral to a physical therapist who specialises in the pelvic floor.

They can help you:

  • learn more on how to use dilators
  • learn about deep relaxation techniques

Living with vaginismus

Sexual dysfunction can take a toll on relationships. Being proactive and getting treatment can be crucial in saving a marriage or relationship. Not to mention improving your overall quality of life.

It’s important to remember that there’s nothing to be ashamed of. Talking with your partner about your feelings and fears about intercourse may help you feel more relaxed.

Your doctor or therapist can provide you with ways to overcome vaginismus. Many people recover and go on to live happy sexual lives.

Scheduling treatment sessions with a sex therapist may be beneficial. Using lubrication or certain sexual positions can help make sexual intercourse more comfortable.

Experiment and find out what works for you and your partner.


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