Vaginismus: Causes, Treatments & Support

Vaginismus causes routine activities such as intercourse or using menstrual products to be painful. Although it is considered one of the most common psychosexual conditions for women, there are no comprehensive statistics of its prevalence among the worldwide population.

In sexual dysfunction clinics, the prevalence of vaginismus is anywhere from 5 to 17 percent, according to the National Institutes of Health. If that statistic were applied to the global female population, it would yield a range of 190 million to 646.5 million women dealing with unbearably painful sex, gynecological exams and tampon insertion.

Effects of vaginismus

Doctors classify vaginismus as either primary or secondary. Primary vaginismus, also called lifelong vaginismus, is when a woman has never inserted anything into her vagina without experiencing extreme pain. Secondary vaginismus is acquired, meaning the difficulty with  penetration develops later in life, even if it wasn’t an issue in the past.

Both types of vaginismus can have serious impacts on your health and quality of life. Some women experience heightened anxiety because they constantly worry about their condition, which can interfere with day-to-day life. For example, women with untreated vaginismus may be anxious about the physical pain of getting preventive health screenings, such as cervical exams, Pap smears and STD checks, and thus may opt not to get those necessary tests.

Physically, vaginismus may make it difficult to express yourself sexually in a relationship, although many people have fulfilling relationships that are nonsexual. The condition can also make it difficult to become pregnant, due to the pain of intercourse.

Vaginismus is not a commonly discussed issue, so there are gaps in statistics about how many women actually suffer from it and don’t seek treatment. Addressing vaginismus with the support of your healthcare provider can significantly lighten the burden of managing this condition alone.

Causes of vaginismus

Many of the factors associated with vaginismus remain unknown. While vaginismus has numerous possible triggers, anxiety is one of the most common causes.

The causes and presentation of vaginismus vary from person to person. Some women tense up before intercourse but can insert a tampon or undergo a gynecological exam. Others experience involuntary contraction in many different scenarios. Trauma, such as rape or sexual abuse, may lead to vaginismus. Vaginal tears during childbirth or a history of surgery can also increase the likelihood of the condition.

Understanding the root cause of vaginismus is the first step to getting proper treatment, especially when psychological issues or emotional pain are thought to be responsible. Unfortunately, there are cases in which vaginismus doesn’t have an exact cause or starting point. It is, however, considered to be a highly treatable condition, and step-by-step programs and online support groups are available.

Physical treatment options

If muscle spasms from vaginismus prevent you from having a pelvic exam, your doctor may use a numbing cream, such as topical lidocaine, to reduce discomfort during medical appointments.

Pelvic floor therapy with a physical therapist can help manage vaginismus. A practice called “progressive desensitization” lets you regain control by voluntarily contracting and relaxing the vaginal muscles. Learning to do Kegel exercises properly and combining them with progressive penetration can help you gradually work your way up to intercourse. Another option is vaginal dilator therapy, which stretches the vagina using tube-shaped devices of different sizes.

Sometimes intravaginal estrogen can be useful in thickening vaginal mucosa and preventing vaginal pain and the anticipatory contractions associated with vaginismus.

While these treatment options address vaginismus’ physical aspects, dealing with psychological factors is essential in many cases.

Mental & emotional support

Therapists trained in cognitive behavioral therapy can help you discover the connection between your mind and body. If you suffer from depression or post-traumatic stress disorder (PTSD), treating these underlying issues can improve your chances of overcoming vaginismus.

Involving your partner in parts of the therapy process builds a stronger foundation of trust, understanding and reassurance. A trained sex therapist can work with you and your partner on a gradual transition to intercourse without pain, giving you exercises and strategies to prepare for sex.

With time, patience and professional support, it’s possible to gain control of your spasms, as well as your physical and mental health.