Table of ContentsView AllTable of ContentsMeaningCauses and TriggersDiagnosisSelf-CareTreatmentCoping
Table of ContentsView All
View All
Table of Contents
Meaning
Causes and Triggers
Diagnosis
Self-Care
Treatment
Coping
Vaginismusis when vaginal muscles tighten involuntarily, causing painful or difficult vaginal penetration. It can affect your experience getting pelvic exams, menstruation, sex, and your mental health. Research estimates between 1% and 7% of women have vaginismus, but this is likely a low estimate due to underreporting; experts estimate that the prevalence is closer to 17%.Treatment options are advancing, and about 71% of people with vaginismus find relief with treatment.
What Vaginismus Means
Vaginismus means your vaginal muscles tighten without you wanting them to, making penetration—with a penis, finger, tampon, or speculum—painful or impossible. It can be something you’ve always had or begin suddenly.
Tightness and Anatomy
During vaginal penetration, you might feel sharp, burning pain or tight pressure. Some describe this as hitting a wall. It can occur at the entrance or deeper inside the vagina.
Effect on Pelvic Exams
Pelvic examscan be painful or impossible for those with vaginismus. Consider asking for a pediatric speculum, longer appointments, or a muscle relaxant prescription if this is the case.
Effect on Menstruation
Effect on Sex
Vaginismus causes pain during attempted penetration, making sexual intercourse or masturbation impossible. Worrying about the pain can also cause panic attacks. The effect of vaginismus on sex can strain relationships because you might avoid sex, or your partner might be afraid of hurting you.
Mental Health Effects
Struggling with vaginismus can make you feel like a failure, leading to feelings of inadequacy and shame. These feelings can create a cycle of isolation and guilt, which might lead to depression, panic attacks, or deep sadness, especially if it affects your hopes of having a family.
Vaginismus Causes and Triggers
The causes and triggers of vaginismus can be physical, emotional, or psychological. Symptoms can start at any age and may not always have a clear cause. Some people experience symptoms with any insertion, while others have issues only with certain partners or during medical exams. Risk factors include:
Steps to Diagnose Vaginismus
Providers typically diagnose vaginismus when you have the following symptoms lasting six months or more:
Conditions That Can Cause Painful SexYour provider may also perform a physical exam, imaging tests, or a urinalysis (peeing in a cup) to rule out the following conditions that could also causepainful sex.EndometriosisOvarian cystsPainful bladder syndromePelvic adhesions (scarring)Pelvic floor dysfunctionPelvic inflammatory disease (PID)Skin problems likelichen sclerosusorlichen planusTipped uterusUnderdeveloped vaginaUterine fibroidsVaginal atrophyor drynessVaginitis (vaginal inflammation)Vulvodynia(chronic vulva pain)
Conditions That Can Cause Painful Sex
Your provider may also perform a physical exam, imaging tests, or a urinalysis (peeing in a cup) to rule out the following conditions that could also causepainful sex.EndometriosisOvarian cystsPainful bladder syndromePelvic adhesions (scarring)Pelvic floor dysfunctionPelvic inflammatory disease (PID)Skin problems likelichen sclerosusorlichen planusTipped uterusUnderdeveloped vaginaUterine fibroidsVaginal atrophyor drynessVaginitis (vaginal inflammation)Vulvodynia(chronic vulva pain)
Your provider may also perform a physical exam, imaging tests, or a urinalysis (peeing in a cup) to rule out the following conditions that could also causepainful sex.
Vaginismus Self-Care for Symptom Management
The following relaxation and breathing techniques can reduce muscle tension and improve vaginismus symptoms.
The following pelvic floor relaxationexercisescan also help:
Kegels vs. Reverse KegelsKegel exercises strengthen weak pelvic floor muscles. However, vaginismus involves tight muscles, so reverse Kegels may be a better choice.Here’s how to do them:Relax the muscles you use to start and stop urine.Imagine gently pushing out.Breathe deeply into your belly while relaxing your pelvic floor.Hold for a few seconds, then release.Repeat several times.
Kegels vs. Reverse Kegels
Kegel exercises strengthen weak pelvic floor muscles. However, vaginismus involves tight muscles, so reverse Kegels may be a better choice.Here’s how to do them:Relax the muscles you use to start and stop urine.Imagine gently pushing out.Breathe deeply into your belly while relaxing your pelvic floor.Hold for a few seconds, then release.Repeat several times.
Kegel exercises strengthen weak pelvic floor muscles. However, vaginismus involves tight muscles, so reverse Kegels may be a better choice.Here’s how to do them:
Vaginismus Medical Treatment
Vaginismus is a treatable condition that often requires a treatment team, including gynecology providers,pelvic floor therapists, psychologists, and sex therapists.
Counseling and Sex Therapy
Psychological counseling addresses emotional and mental challenges. A sex therapist can teach you about:
Pelvic Floor Physical Therapy
A pelvic floor physical therapist can guide you through exercises and exposure therapy, gradually inserting your fingers orvaginal dilatorsinto the vagina. Vaginal dilators are devices that help stretch the vaginal wall, making penetration more comfortable.
Medications and Procedures
The following medications and procedures can also help:
Coping With Chronic Vaginismus
Living with vaginismus can be challenging. Consider connecting with others who understand through support groups or online forums.If you are beginning dilator treatment, be patient with yourself and go at your own pace. It can be more emotional than you might expect. Here are a few other vaginal dilator tips:
Summary
Vaginismus is when the muscles around the vagina tighten, making penetration difficult. Symptoms include pain during sex, trouble inserting tampons, and difficult or impossible pelvic exams. Underlying causes can be physical and psychological. Living with vaginismus can be frustrating, but many people get relief with self-care or medical treatments.
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Pithavadian R, Dune T, Chalmers J.Patients' recommendations to improve help-seeking for vaginismus: a qualitative study.BMC Womens Health. 2024;24(1):203. doi:10.1186/s12905-024-03026-xPacik PT, Geletta S.Vaginismus treatment: clinical trials follow up 241 patients.Sex Med. 2017;5(2):e114-e123. doi:10.1016/j.esxm.2017.02.002Hill DA, Taylor CA.Dyspareunia in women.Am Fam Physician. 2021;103(10):597-604. PMID:33983001.Anğın AD, Gün İ, Sakin Ö, et al.Effects of predisposing factors on the success and treatment period in vaginismus.JBRA Assist Reprod. 2020;24(2):180-188. doi:10.5935/1518-0557.20200018Toussaint L, Nguyen QA, Roettger C, et al.Effectiveness of progressive muscle relaxation, deep breathing, and guided imagery in promoting psychological and physiological states of relaxation.Evid Based Complement Alternat Med. 2021;2021:5924040. doi:10.1155/2021/5924040National Association for Continence.How to relax your pelvic floor.National Association for Continence.Ask the doc: Can kegels really help my OAB symptoms?American College of Obstetricians and Gynecologists.When sex is painful.American College of Obstetricians and Gynecologists.Treatment of urogenital symptoms in individuals with a history of estrogen-dependent breast cancer.Rapkin AJ, Satmary W.A deep dive into devices for sexual health.Contemporary OB/GYN Journal. 2024;69(2).
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Pithavadian R, Dune T, Chalmers J.Patients' recommendations to improve help-seeking for vaginismus: a qualitative study.BMC Womens Health. 2024;24(1):203. doi:10.1186/s12905-024-03026-xPacik PT, Geletta S.Vaginismus treatment: clinical trials follow up 241 patients.Sex Med. 2017;5(2):e114-e123. doi:10.1016/j.esxm.2017.02.002Hill DA, Taylor CA.Dyspareunia in women.Am Fam Physician. 2021;103(10):597-604. PMID:33983001.Anğın AD, Gün İ, Sakin Ö, et al.Effects of predisposing factors on the success and treatment period in vaginismus.JBRA Assist Reprod. 2020;24(2):180-188. doi:10.5935/1518-0557.20200018Toussaint L, Nguyen QA, Roettger C, et al.Effectiveness of progressive muscle relaxation, deep breathing, and guided imagery in promoting psychological and physiological states of relaxation.Evid Based Complement Alternat Med. 2021;2021:5924040. doi:10.1155/2021/5924040National Association for Continence.How to relax your pelvic floor.National Association for Continence.Ask the doc: Can kegels really help my OAB symptoms?American College of Obstetricians and Gynecologists.When sex is painful.American College of Obstetricians and Gynecologists.Treatment of urogenital symptoms in individuals with a history of estrogen-dependent breast cancer.Rapkin AJ, Satmary W.A deep dive into devices for sexual health.Contemporary OB/GYN Journal. 2024;69(2).
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Pithavadian R, Dune T, Chalmers J.Patients' recommendations to improve help-seeking for vaginismus: a qualitative study.BMC Womens Health. 2024;24(1):203. doi:10.1186/s12905-024-03026-xPacik PT, Geletta S.Vaginismus treatment: clinical trials follow up 241 patients.Sex Med. 2017;5(2):e114-e123. doi:10.1016/j.esxm.2017.02.002Hill DA, Taylor CA.Dyspareunia in women.Am Fam Physician. 2021;103(10):597-604. PMID:33983001.Anğın AD, Gün İ, Sakin Ö, et al.Effects of predisposing factors on the success and treatment period in vaginismus.JBRA Assist Reprod. 2020;24(2):180-188. doi:10.5935/1518-0557.20200018Toussaint L, Nguyen QA, Roettger C, et al.Effectiveness of progressive muscle relaxation, deep breathing, and guided imagery in promoting psychological and physiological states of relaxation.Evid Based Complement Alternat Med. 2021;2021:5924040. doi:10.1155/2021/5924040National Association for Continence.How to relax your pelvic floor.National Association for Continence.Ask the doc: Can kegels really help my OAB symptoms?American College of Obstetricians and Gynecologists.When sex is painful.American College of Obstetricians and Gynecologists.Treatment of urogenital symptoms in individuals with a history of estrogen-dependent breast cancer.Rapkin AJ, Satmary W.A deep dive into devices for sexual health.Contemporary OB/GYN Journal. 2024;69(2).
Pithavadian R, Dune T, Chalmers J.Patients' recommendations to improve help-seeking for vaginismus: a qualitative study.BMC Womens Health. 2024;24(1):203. doi:10.1186/s12905-024-03026-x
Pacik PT, Geletta S.Vaginismus treatment: clinical trials follow up 241 patients.Sex Med. 2017;5(2):e114-e123. doi:10.1016/j.esxm.2017.02.002
Hill DA, Taylor CA.Dyspareunia in women.Am Fam Physician. 2021;103(10):597-604. PMID:33983001.
Anğın AD, Gün İ, Sakin Ö, et al.Effects of predisposing factors on the success and treatment period in vaginismus.JBRA Assist Reprod. 2020;24(2):180-188. doi:10.5935/1518-0557.20200018
Toussaint L, Nguyen QA, Roettger C, et al.Effectiveness of progressive muscle relaxation, deep breathing, and guided imagery in promoting psychological and physiological states of relaxation.Evid Based Complement Alternat Med. 2021;2021:5924040. doi:10.1155/2021/5924040
National Association for Continence.How to relax your pelvic floor.
National Association for Continence.Ask the doc: Can kegels really help my OAB symptoms?
American College of Obstetricians and Gynecologists.When sex is painful.
American College of Obstetricians and Gynecologists.Treatment of urogenital symptoms in individuals with a history of estrogen-dependent breast cancer.
Rapkin AJ, Satmary W.A deep dive into devices for sexual health.Contemporary OB/GYN Journal. 2024;69(2).
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