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If you’re experiencing painful sex, difficulty inserting a tampon, or extra discomfort during an annual pelvic exam, you may be suffering from vaginismus. Vaginismus is an involuntary tensing of the vagina which can make vaginal intercourse, and other acts of vaginal penetration extremely difficult. Though vaginismus is uncomfortable and can interfere with people’s everyday routines, there are interventions to help relax muscles and stop painful spasms.

What is Vaginismus?

Vaginismus is the involuntary tensing or contracting of muscles around the vagina. These occur when a penis, finger, tampon, medical instrument, or sex toy attempts to penetrate the vagina. The spasms range from mildly uncomfortable to extremely painful and may prevent the item from entering the vagina, even if the person with vaginismus is trying to insert the object.

The main symptoms of vaginismus are:

  • Discomfort or pain during vaginal penetration
  • Inability to have sex or complete a pelvic exam because of muscle spasms or pain
  • Painful intercourse

What causes vaginismus?

Vaginismus might appear the first time a person tries to insert a tampon, have a pelvic exam, or have sex for the first time. Though vaginismus is involuntary, scientists believe it may be associated with general anxiety or fears around sex or penetration. In this way, vaginismus might develop for a person in their late teens or early twenties as they start to engage in sexual behavior and regularly visit a gynecologist.

Alternatively, a person might develop vaginismus later in life after a childbirth injury, surgery, or event of sexual abuse or trauma. Vaginismus can develop after years without any discomfort, and some may only experience selective vaginismus, meaning they might have no trouble inserting a tampon, but may struggle to have a pelvic exam.

How is vaginismus treated?

Vaginismus treatment focuses on relaxing the reflexes of the vagina to avoid tensing up. This can be done through physical therapy and psychotherapy to address anxieties or fears that may be contributing to vaginismus.

Here are a few treatment options for vaginismus:

  1. Topical Therapy: Lidocaine or certain creams may ease the pain associated with vaginismus spasms.
  2. Pelvic Floor Physical Therapy: During physical therapy, an expert will walk the patient through exercises like Kegels or other stretches which will help to relax the pelvic floor.
  3. Vaginal Dilator Therapy: Vaginal dilators can be purchased online or through your doctor to help treat vaginismus. These dilators are a series of tube-shaped devices that vary in diameter which work to stretch the vagina over time. The goal of dilators is to allow people with vaginismus to become more comfortable with vaginal penetration.
  4. Cognitive Behavior Therapy / Sex Therapy: CBT is a specific type of therapy which helps patients understand how their thoughts affect their emotions and behaviors and has had great success in treating patients with anxiety, depression, and PTSD. Separately, sex therapy can help individuals to find pleasure in their sex lives and may be a great additional resource for people with vaginismus.

While vaginismus may be painful and interfere with a person’s life for several months to years, it is possible to receive treatment and experience sex and pelvic exams without pain. If you think you might be suffering from vaginismus, reach out to your OB/GYN to discuss your symptoms and move forward with treatment.