How to cope with vaginismus


Vaginismus not only interferes with normal sexual life, but also does not allow women to insert tampons or undergo gynecological examinations. The causes of vaginismus may be different and it is necessary to identify them for the purpose of treatment. Although this condition can be frustrated, embarrassed and strained, it is completely treatable.

Vaginism detection

Take seriously the painful sex. The first and most disturbing symptom of vaginism is pain during an attempt at sexual intercourse. Different women may have different feelings - it may be a burning sensation, tingling, tension, rupture or as if the partner "hits the barrier." Often the pain and involuntary muscle contractions are so strong that you have to stop sexual intercourse.

    Many women discover this problem when they first try to have sex. This is called primary vaginismus.
    In other women, vaginismus develops throughout life - this is called secondary vaginismus. Therefore, you should not ignore this important symptom just because in the past you have had sex without pain.
Pay attention to other problems with vaginal penetration. In addition to pain during intercourse, women with vaginismus may have problems with other types of penetration, including the introduction of a tampon and pelvic examinations. Other features also include:

    not consensual marriage;
    persistent sexual discomfort after childbirth, candidiasis, urinary tract infections, STDs, interstitial cystitis, hysterectomy, cancer and surgery, rape or menopause;
    pain during intercourse of unknown origin;
    stop breathing during an attempt to have intercourse;

Pay attention to other muscle spasms. Vaginal muscle contractions and spasms are a hallmark of vaginism, but some women also have cramps in the legs or lower back. These cramps occur most often during sexual intercourse attempts.
Think about whether you avoid sex. Many women with vaginismus avoid situations that can lead to sex. If you avoid sexual activity, or romance, because you are afraid of pain and feel uncomfortable because of your symptoms, then you should seek medical help.

    Remember that you avoid sex through no fault of your own, but because your body involuntarily associates sex with pain.

Consult a doctor. Make an appointment with your doctor or gynecologist to discuss vaginismus. Be clear about the extent and severity of your symptoms.
Eliminate other possible violations. Your doctor should conduct a pelvic exam and pay attention to any discomfort or vaginal contractions that may occur. In addition, he will probably recommend additional tests to rule out other possible causes of your symptoms.

    The cause of vaginismus may be obvious physical causes, for example: infections, injuries or supersensitive nerves in the vaginal area (provoked vulvodynia).

It is necessary that a correct diagnosis be made. If all other possible causes of your symptoms are excluded, the doctor can diagnose you with either primary vaginismus or secondary vaginismus. In addition, the doctor may describe the violation as common if symptoms appear in all situations related to the administration, or as situational if symptoms only appear in certain situations (for example, during an attempt to have sex).

    Unfortunately, female sexuality and sexual dysfunction are not fully understood. You may encounter a medical staff who ignores your symptoms or cannot help you. In this case, you may have to show perseverance to undergo diagnosis and receive treatment. If your doctor does not help you, contact another doctor, preferably one who has experience in treating vaginism and other forms of female sexual dysfunction.
    Other possible diagnoses include: apareunia - a general term for the inability to have sexual intercourse (in particular, vaginismus is one of the types) and dyspareunia - pain during intercourse.
    These diagnoses will help advance the treatment, giving you the opportunity to contact the right specialists.

Understanding the causes of vaginismus

Be aware that vaginismus is often associated with anxiety. Many women with vaginismus may notice that their symptoms are associated with stress, anxiety and fear. These causes may have deep roots or they may simply be related to the current standard of living, such as lack of sleep and stress associated with overworking at work.
Identify the underlying concepts of sex and sexuality. Women suffering from vaginismus are more likely to negatively think about sex and sexuality. These feelings may be rooted in childhood, or they may be associated with some traumatic event.

    If the hidden negative ideas about sex come from early childhood, then another potential component of vaginism may be the lack of proper sex education.

Be aware of the role of past experience. It has been established that women suffering from vaginismus experienced a traumatic event of a sexual nature in childhood twice as often. It could be injuries of varying severity, which include:

    sexual harassment by a friend;
    sexual abuse;
    pelvic injuries;
    violence in family;
    extremely negative early sexual experience with a consensual partner.

Be aware that relationship difficulties could contribute. If you have secondary and situational vaginism, they can be caused by problems with a sexual or romantic partner. These problems may include: lack of trust, fear of commitment, fear of becoming too vulnerable or open to pain and frustration.

Understand that medical disorders can play a role. Various disorders can provoke or aggravate the symptoms of vaginism. This is more likely if vaginismus appears after a period of normal sexual functioning. Potential medical disorders that may contribute to the appearance of vaginismus:

    urinary tract infections and other urinary problems;
    sexually transmitted infections;
    cancer of the genital or reproductive organs;
    pelvic inflammatory disease;
    vulvodynia or vestibulodynia.
        Vaginism can also be caused by medical procedures related to the female reproductive organs, such as the removal of the uterus.

Be aware of the potential role of reproductive periods. For many women, the onset of secondary vaginism is associated with childbirth. This is especially true if the birth was severe or if the birth resulted in injuries to the genitals. Some women have vaginism due to hormonal changes and vaginal dryness, usually occurring during menopause.

    Secondary vaginismus may also arise as a consequence of the fear of having children or the need to survive childbirth.

Admit the possibility that there are no visible reasons. Some women will never know why they have vaginismus. They have no visible or hidden causes of vaginismus.

    Some studies have even suggested that the symptoms of vaginismus are part of the general defense mechanisms that run in threatening situations. This suggests that it is not always necessary to consider it as a predominantly sexual dysfunction.

Treatment of vaginismus

Try psychological counseling. A psychotherapist can help you regardless of whether your vaginismus is caused by emotional or psychological problems. This is because awareness of the state itself often gives rise to fear and anxiety about sexual intercourse, forming a vicious circle that only exacerbates the symptoms. Depression, feelings of isolation and low self-esteem are also characteristic signs of sexual dysfunction.

    The results of treatment are much more positive when the woman and her sexual partner are motivated, act in concert and are determined to reduce conflicts in the relationship. Thus, the psychological assessment of a couple is an excellent start for treatment.
    If vaginismus is associated with anxiety disorder or sexual trauma in the past, then a therapist can help you deal with these problems so that you can move on.
    One type of psychotherapy, cognitive-behavioral psychotherapy, may be especially useful for some women. This type of psychotherapy focuses on the relationship between thoughts and behavior, and a cognitive behavioral therapist can help change your thoughts and behavior regarding the desire to avoid sex.

Ask about exposure therapy. One type of treatment for vaginismus is called exposure therapy, or “immersion,” which involves a gradual decrease in sensitivity to penetration. Help the psychotherapist in penetration is an effective treatment, even if a woman lives with vaginismus for the rest of her life. Exposure techniques are usually associated with vaginal penetration exercises using dilators.

    The same method is used for self-treatment with the help of a consultant who would help to move on without losing confidence in success.

Find a physiotherapist. Ask your doctor to refer you to a physical therapist who has experience with vaginismus and other forms of female sexual dysfunction. Since pelvic floor muscles play an important role in the appearance of vaginism symptoms, physiotherapy is one of the best treatments. A physical therapist can:

    teach you how to breathe and relax
    help you with the pelvic floor muscle contraction by teaching them to control

Do kegel exercises. The kegel exercise is designed to help control the pelvic floor muscles. To make a Kegel exercise, squeeze the muscles you use to stop the flow of urine, hold them for a few seconds, and then relax. Try to make about 20 cuts at a time as often during the day as you can.

    Some doctors recommend doing Kegel exercises with a finger inserted into the vagina (you can use up to three fingers). Finger allows you to feel the contracting muscles to better control them.

Consider using vaginal dilators. Your doctor may recommend using vaginal dilators at home. These are cone-shaped instruments that are placed in the vagina. They gradually increase, allowing the vaginal muscles to stretch and get used to penetration.

    For starters, tuck as with a bowel movement. It helps to enlarge the vagina. Then insert the fingers (until without the dilator) into the vagina, while continuing to push or push.
    When you start using extenders, leave them for 10-15 minutes. Vaginal muscles will get used to the pressure.
    If you have a spouse or partner, you can ask him to help you insert extenders.

Start sex gradually. Women with vaginismus need to be patient and try different treatment options before engaging in sex. If you try to immediately become sexually active, you may experience pain or discomfort, thereby tuning in to pain and anxiety and aggravating vaginismus. It is very important that your partner provide support.

    When you try to have sex, then start very slowly, using a large amount of lubricant, while experimenting to find the most convenient positions.
    Doctors, as a rule, advise women, when they stop using vaginal dilators, to hold the penetrating object by placing it partially or completely into the vagina. This applies equally to penises, dildos and vibrators.


Some women are so embarrassed and ashamed of their condition that they do not seek medical help. If you are experiencing these feelings, remember that vaginismus is not your fault, and that this disorder is treatable. Find a sympathetic doctor and a good therapist who can help you find a normal sex life.
Some doctors and websites may recommend medications, including local anesthetics, for the treatment of vaginismus. However, in general, this is not a good idea: local anesthetics reduce pain, but they will not help to solve the problem itself, and it may be even harder for you to cope with this condition.

Classification of vaginismus

Under primary vaginismus understand the difficulties encountered when trying to hold the first sexual intercourse; under the secondary - violations that developed after the start of sexual life. There is a precoital form of vaginism, arising exclusively during attempts at sexual intercourse, and a generalized form that occurs reflexively, including the introduction of tampons, gynecological examination and other situations.
There are 3 degrees of severity of vaginismus. A mild degree is characterized by muscle spasm that arises in response to the introduction into the vagina of the instrument, the doctor’s finger, and the penis. With a moderate severity of vaginismus, a reflex reaction should occur when touching the genitals. Severe vaginism corresponds to a spasm that occurs when thinking about a gynecological examination or intimacy.
True vaginism should be distinguished from pseudo-aginism - muscle spasm that develops in response to pain stimuli in injuries, structural anomalies (vaginal atresia or hymen), female genital tract diseases (colpitis, bartholinitis, genital herpes, dry mucous, anus cracks, anus, cracks, anples, colpitis, bartholinitis, genital herpes, dryness of the mucous membrane, anus, cramps of the anus, colpitis, bartholinitis, genital herpes, dryness of the mucous membranes of the woman (colpitis, bartholinitis, genital herpes, dryness of the mucous membrane of the woman) into the vagina, etc.). Also, vaginismus should not be confused with coitophobia - the fear of sexual intercourse, which is not accompanied by spastic muscle contraction.

Causes of Vaginismus

It has been proven that the causes of vaginism are psychogenic in nature and are often associated with neurasthenia, obsessive-compulsive disorder, and hysteria. Vaginismus with neurasthenia is caused by a general increased nervous excitability and is caused by an unconditional protective reaction, and not by fear of sexual intimacy. This symptom complex is often found in some somatic diseases - thyrotoxicosis, traumatic cerebrosis.
Vaginismus in psychasthenia (obsessive-compulsive disorder) is in the nature of phobias, that is, associated with an obsessive fear of sexual relationships or gynecological examination. Vaginism often develops in suspicious, anxious women under the influence of ideas or their own negative experience of painful defloration or sexual intercourse (due to the rigidity of the hymen, vulvovaginitis, insufficient stimulation, cracks and tears of the vaginal mucosa).
In hysteria, vaginismus is regarded as an escape to the disease - the conscious or unconscious reluctance of the woman to enter into intimate relationships with a particular man. The causes of vaginism in hysterical types may be in a forced marriage, aversion to a partner, rudeness of his behavior, violence, erectile dysfunction in a man, etc. Vaginismus occurs more often in non-deflated patients, although it may develop in women in marriage, even after having children .

Manifestations of vaginismus

Manifestations of vaginismus are usually associated with the onset of sexual activity. Convulsive muscle spasm develops against the background of fear and expectation of painful defloration, but it can occur suddenly, completely unexpectedly for a woman. With vaginism, a sharp contraction of the muscles of the vagina, perineum, thighs, pelvic floor, abdominal wall develops in response to touching the genitals, trying to insert the penis, or even thoughts about intimacy. Similar reactions may occur with the introduction of a hygienic tampon, vaginal examination or an attempt to carry it out.
If the spasm develops when touching the genitals, then committing coitus becomes impossible. When a spasm occurs after the introduction of the penis, it can be injured with the inability to extract from the vagina, which is accompanied by severe pain and swelling of the penis. In the history of many patients with vaginismus, various kinds of childhood fears, dysmorphophobia, sleep disorders, and depression are noted.
With neurasthenic disorders, mild or moderate vaginism is usually noted, with phobic neurosis, moderate or severe severity, with hysteria, moderate severity. Psevdovaginizm characteristic of healthy women in mental health and is associated with pain syndrome, forming a strong reflex connection with the repetition of pain. Many women suffering from vaginismus retain the ability to achieve sexual arousal and orgasm, and their seeking help from a doctor is associated with a feeling of inferiority or a desire to have a child.

Prognosis for vaginism

The prognosis of patients with vaginismus in terms of restoring a normal sex life is often favorable. In the future, women can plan pregnancy.