Vaginismus: Does sex cause you pain?

What is vaginismus?

Vaginismus is a spasm of the muscles in the perineum and vagina. In this case, the vagina has difficulty or is unable to accommodate the penis or other objects. In severe cases, this makes medical examinations and using tampons impossible, besides putting up a major barrier to experiencing joyful sexuality.

According to a 2001 study, the occurrence of sexual dysfunction is very high in the general population, above 46%. Part of this is related to various painful intercourse experiences that affect women. The prevalence of vaginismus is estimated to be between 1-6%, although the number of women visiting a sexual psychologist specifically with this issue is showing a growing trend.

What are the symptoms?

1. muscle tension – this can affect only the vaginal sphincter, but can also extend to the pelvic floor muscles, back, jaw, or even the entire body

2. fear of pain – this may relate specifically to touching intimate parts, intercourse, sexuality in general, or response to pain in general

3. behavioral tendencies of the person to approach or avoid 

In some cases, there are gynecological, medical, or biological reasons behind it (like vaginitis, a rigid hymen, injury, congenital disorder, or endometriosis), but even in these cases, we meet accompanying mental challenges, like anxiety, fear of pain, and stress.

In most cases, however, vaginismus is caused by mental (psychological) reasons:

• FEAR: painful intercourse, injury, getting pregnant, physical harm, return of illnesses, loss of control

• ANXIETY: coming from inexperience, pressure to perform, eager to please, or bad past experiences

• GUILT: overly strict parents, childhood shaming, sex-negative upbringing, religious upbringing

• TRAUMA: sexual violence, bad circumstances during loss of virginity, mental scars suffered in previous sexual relationships

• RELATIONSHIP ISSUES: growing apart emotionally, commitment issues, attachment problems, fear of disappointment, lack of trust, poor communication

  It is good to know that vaginismus can always be overcome, especially with a multidisciplinary, combined treatment involving multiple specialties.

1.  Check in with your gynecologist, and find out the physical background of your problem. If everything is fine, go see a good sexual psychologist; if a physical cause is found, get started with the right treatment.

2. Look for a sexual psychologist, who will provide you with helpful sexual education. It is super important to understand how sexuality works, the connection between your body and mind, and how you can influence your body. Cognitive behavioral therapy, as a psychological method, has a very good set of tools to treat vaginismus.

3. Be prepared that you might also need help from a physiotherapist to improve your condition. Learning certain exercises, like properly training your vaginal muscles, and learning various pelvic floor relaxation exercises, can be essential for the treatment. 

If you recognized yourself while reading this, reach out for help as soon as possible! Every single day matters in your life, never forget that! 😌

Frequently asked questions

How can I tell vaginismus apart from simple first-time jitters?

While excitement is natural and gets resolved as the body relaxes, with vaginismus, the involuntary and strong spasm of your muscles makes penetration almost physically impossible.

What should I do if I am afraid of being left because of my vaginismus?

Tell your partner honestly that this is a physical response beyond your control, which is not about lack of desire, and ask them to support you patiently on the journey to getting better together.

Can I use dilators at home, or will they only make things worse?

Special dilators can be very effective in helping your body relearn how to relax and receive, once you get proper guidance from a specialist (like a physiotherapist or psychologist).

How long do I need to go to therapy to heal completely?

Everyone heals at their own pace, but with complex treatment (psychologist and physiotherapy), you can usually reach comfortable and pain-free intercourse in a few months.

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Source: Szexuálpszichológia. Hevesi, Rigó, Urbán. Budapest, 2020.