Vaginismus

What is vaginismus?

Vaginismus is when the vaginal muscles involuntarily contract and tighten, usually when the vulva is touched. It can happen before sex, when inserting a tampon, or during a gynaecological examination.

Vaginismus can cause pain and discomfort and prevent sexual penetration. It can also make it impossible to undergo a pelvic examination.

There are two types of vaginismus:

• Primary — when complete vaginal penetration has never been achieved
• Secondary — when penetration has been achieved in the past without pain, but is no longer possible

What causes it?

There is no one cause of vaginismus and researchers don’t know exactly why it occurs. However, a number of physical and psychological factors could be involved. These include:

• medical conditions such as recurrent urinary tract infections (UTIs), yeast infections (thrush), chronic pain syndromes or endometriosis
• trauma associated with childbirth
• previous painful pelvic examination
• previous painful or unpleasant sex
• previous sexual assault or rape
• fear of becoming pregnant
• fear of penetration hurting due to a belief that the vagina is too small
  

What you can do

If you notice any problems with your vulva or vagina, it’s important to speak to your doctor.

Your doctor will ask about your medical history, your sexual history which may include questions about sexual trauma or abuse, and about the kind of symptoms you have. They will also perform a pelvic examination, but if your doctor suspects vaginismus, they will be extremely gentle.

The most effective treatment often involves a multidisciplinary approach and may include number of health professionals such as:

• a GP
• a pelvic floor physiotherapist
• a psychologist
• a sex therapist.

This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at April 2021.