Vaginismus

Overview, Causes, & Risk Factors

Vaginismus is painful, reflex muscle spasm of the vagina and leg muscles, which occurs when sexual intercourse is tried or anticipated.

What is going on in the body?

When a woman has vaginismus, muscle spasms cause the vagina and leg muscles to tighten reflexively. Putting a finger or penis in the vagina is quite painful. Often it cannot be done.
The problem is often linked to past sexual trauma. Other factors, such as fear of pregnancy or venereal disease, may also be present.

What are the causes and risks of the condition?

Some contributing factors are:

past sexual trauma, as a child, teen, or adult

sexual inhibition for religious, cultural or emotional reasons

pain with intercourse in the past

desiring women rather than men, even if the desire is not acted upon

painful pelvic exams

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Symptoms & Signs

What are the signs and symptoms of the condition?

The key symptom of vaginismus is vaginal tightness strong enough to make intercourse impossible. The pain may cause a woman to avoid sexual intimacy.

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Diagnosis & Tests

How is the condition diagnosed?

A healthcare provider will take a medical history and ask about episodes of vaginismus. A pelvic exam will be done, too. During it, the provider will try to gently insert a finger or fingers into the vagina to see if this causes a painful spasm of vaginal muscles and tightened leg muscles.

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Prevention & Expectations

What can be done to prevent the condition?

Sexual abuse is a complex problem. Raising awareness and a healthy suspicion through education, identifying abusers and offering protection are key issues.

By speaking positively about sexuality, parents may help remove, or at least not encourage first-time fears. This may help children accept their own sexual preferences, too.

If intercourse is always painful, a healthcare provider can offer treatment. That may help prevent a worsening cycle of vaginismus.

What are the long-term effects of the condition?

Because sexual activity is painful for a woman with vaginismus, relationships are often avoided, or marred by discord and dissatisfaction. Lingering questions about sexual preference may never be resolved.

What are the risks to others?

A woman's partner may start to view himself as a sexual failure. Problems having an erection or impotence may result.

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Treatment & Monitoring

What are the treatments for the condition?

Treatment usually involves counseling to get at the root psychological cause for the vaginismus. Some experts use a program that slowly makes it easier to relax vaginal muscles so that the vagina opens up. A reputable sex therapist or gynecologist familiar with the problem may suggest:

placing the woman's fingers or her partner's fingers in the vagina and learning to relax.

placing dilators of increasing size into the vagina daily. Over many weeks this helps open up the vagina and relax the muscles.

seeking sex therapy with a goal of having intercourse and a healthy, satisfying sexual relationship. Sessions may involve education about female and male anatomy, how sexual response works, and common myths about sex. If a phobia exists, hypnosis and relaxation techniques may be useful, too. Success rates are high. Within 10 to 15 sessions, about 90% of women with vaginismus respond to therapy.

What are the side effects of the treatments?

Until a woman is able to relax her muscles, using dilators in the vagina may be uncomfortable and irritating. Therapy may uncover difficult issues that could trigger deep depression or anxiety.

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Attribution

Author:Eva Martin, MD
Date Written:
Editor:
Edit Date:
Reviewer:Sandy Keefe, RN, MSN
Date Reviewed:09/11/01

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