Vaginismus

What is vaginismus?

Vaginismus is when your pelvic floor muscles involuntarily tighten. There are 2 types of vaginismus:

• Primary – where vaginal penetration has never been achieved.
• Secondary – where vaginal penetration was possible but is no longer possible for different reasons.

Symptoms of vaginismus

The main symptom of vaginismus is the involuntary tightening of your pelvic floor muscles in the lower part of your vagina. This can cause symptoms of pain and discomfort with any attempted vaginal penetration.

Read Amanda’s story about living with severe vaginismus.

What causes vaginismus?

Vaginismus can occur for many reasons. It may be associated with physical factors, such as:

• medical conditions, for example recurrent urinary tract infections (UTIs), thrush, persistent pain syndromes, endometriosis
• sexually transmitted infections (STIs) and ongoing pain after an STI has been treated
• vulval skin conditions, for example lichen sclerosis and lichen planus
• vulval pain, including changes to the vulval skin and lining of the vagina, which happens at menopause.

Psychological factors may play a role. For example, fear due to trauma during childbirth or surgery, or negative ideas about sex.

Fear may also be due to previous experience of:

• painful vaginal examinations
• painful sex (dyspareunia)
• sexual assault or rape.

Other psychological factors might include:

• anxiety
• depression
• relationship problems
• feeling self-conscious
• fear of intimacy
• fear of pregnancy
• lack of arousal.

Vaginismus can cause some women to avoid situations where attempts at vaginal penetration might occur, for example, dating, sex and pelvic examinations. Past experiences of pain can set up a cycle of fear of pain and muscle contraction.

How is vaginismus diagnosed?

Vaginismus is usually diagnosed via a clinical examination. During your first visit, your doctor will ask about your symptoms and medical, family and sexual history. They may also ask about sexual trauma and abuse. If your doctor suspects vaginismus, they may ask if it’s okay to do a gentle physical examination – although this may not be possible.

Treatments for vaginismus

Your doctor or specialist will recommend different treatment options depending on your individual situation. Common treatments include:

• pelvic floor physiotherapy, for example, pelvic floor muscle relaxation exercises, gentle massage, equipment such as biofeedback and vaginal trainers
• counselling or therapy
• medicine to help with any persistent pain issues.

When to see your doctor

If you have any concerns about your vulva or vagina, it’s important to see to your doctor. Treatment for vaginismus may involve different health professionals such as:

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

Related resources

Download our vaginismus fact sheet.