Vaginismus is a condition where the muscles around the vagina tighten involuntarily, which can make penetration or vaginal insertion painful, difficult, or sometimes not possible. These muscle responses are not under conscious control and can occur during sexual activity, tampon or menstrual product insertion, or gynaecological examinations.
Vaginismus can be influenced by a range of physical, emotional, and psychological factors. With appropriate, individualised support, many people can experience significant improvements in comfort, confidence, and sexual wellbeing.
Symptoms:
The main symptom of vaginismus is involuntary tightening of the muscles around the vagina when something is being inserted, which can make penetration painful, difficult, or not possible. This may occur with medical examination equipment, menstrual products, sex toys, fingers, or a penis.
Causal factors:
Vaginismus can be influenced by a range of experiences and circumstances. These may include painful or traumatic sexual experiences, unpleasant medical experiences such as painful examinations or thrush, difficult births, sexual shame, or fear and anxiety around sex and penetration.
The muscle contractions associated with vaginismus are involuntary and not under conscious control. Importantly, vaginismus does not reflect a lack of sexual desire or arousal.
How Therapy Helps:
Sex therapy starts by understanding the pain, including when it occurs, what may be contributing to it, and how the mind and body respond. Therapists can also help reframe stressful thoughts around penetration, such as “it will always hurt” or “my body is broken”.
Education and practical strategies can help clients understand the relationship between pain and anxiety, manage difficult emotions, and reduce self-blame. Clients are also encouraged to pause penetration attempts and explore intimacy without a focus on penetration.
Relaxation techniques, mindfulness, breathwork, and Sensate Focus may be introduced to gradually build comfort with sensual touch. When ready, penetration exercises such as vaginal trainers can be used to gradually increase comfort with vaginal penetration.
Sex therapy can be undertaken individually or with a partner. Couples therapy can help partners better understand vaginismus, reduce pressure around penetration, communicate supportively, and build intimacy outside of penetration.