Vaginismus is a condition that can make sex difficult, causing an involuntary tightening of the vagina that makes penetration difficult. If you suspect you have it, it's important to talk to your OB-GYN and a sex therapist to learn more about the reasons, symptoms, and signs, as well as the available treatment options. This condition can be experienced by some women and can be a lifelong problem, causing them to avoid penetration altogether. However, it's important to note that the majority of cases of painful sex are temporary and easily fixable.

What is vaginismus?

Vaginismus is a condition in which the muscles in the vaginal area involuntarily contract, making penetration very difficult or even impossible. This can be caused by a variety of factors, and can make sex extremely painful. The pelvic floor muscles, located at the vaginal entrance, contract rapidly during entry, creating a barrier that makes it difficult or impossible for penetration to occur. According to sex therapist Jordan Rullo, Ph.D., many people with vaginismus describe the feeling as if their vagina is hitting a wall during penetration, making it impossible to continue.

What causes vaginismus?

Vaginismus may be caused by various factors and it is not always clear what causes it. Risk factors such as history of sexual trauma, chronic vulvar infections, vulvar skin conditions and medical procedures like traumatic birth may increase the likelihood of developing vaginismus. Studies also suggest that people who are prone to anxiety may have a higher prevalence of the disorder. However, in some cases, there is no clear explanation for why it develops.

Is vaginismus common?

The prevalence of vaginismus is hard to determine as many patients do not receive a diagnosis. Research shows that it affects 5-17% of women in clinical settings, but it is likely underdiagnosed. The concept of vaginismus is relatively new, but it is becoming more widely recognized with the help of television shows and increased awareness. Vaginal pain affects people of all genders and is often accepted as a normal part of life.

I think I have vaginismus, what should I do?

If you suspect that you may have vaginismus, it is important to take action. The first step is to abstain from any sexual activity that causes discomfort. Then, seek help from a gynecologist or other healthcare professional for examination and diagnosis. It is also important to advocate for yourself and seek multiple opinions if needed, in order to receive an accurate diagnosis.

Treatments for vaginismus

Once vaginismus is diagnosed, various types of therapy may be used to manage feelings around penetration and reduce fear and anxiety while gradually becoming accustomed to physical sensations. These therapies may include talk therapy such as cognitive behavioral therapy, pelvic floor exercises with the use of dilators, physical therapy, and sensate focus exercises. Medication options may include topical estrogen, lidocaine, gabapentin, antidepressants and neuropathic pain medications. It is important to note that the treatment process takes time and consistency.

The takeaway

Vaginismus can be treated with the right care and attention. It is important to seek help from a healthcare professional, and be prepared to advocate for yourself. Different types of therapy, such as talk therapy, pelvic floor exercises, sensate focus, and medication may be used to manage the condition. Studies have shown that 71% of patients with vaginismus reported pain-free sex after 5 weeks of treatment. It is important to be patient with yourself and understand that there is no one easy fix for the condition, but with time and the right combination of treatments, relief can be found.