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About Vaginismus

Description, Condition, Types

What is Vaginismus?

Vaginismus [vaj-uh-niz-muhs] is vaginal tightness causing discomfort, burning, pain, penetration problems, or complete inability to have intercourse. The vaginal tightness results from the involuntary tightening of the pelvic floor (especially the pubococcygeus (PC) muscle group), although the woman may not be aware that this is the cause of her penetration or pain difficulties.

The Vaginismus Condition

Vaginismus is a condition where there is an involuntary tightness of the vagina during attempted intercourse. While the source of the tightness may be unclear, the tightness is actually caused by the involuntary contractions of the pelvic floor muscles surrounding the vagina. Due to the involuntary nature, the woman does not directly control or 'will' the tightness to occur; it is a reflexive pelvic response. She may not even have any awareness that the muscle response is the cause of the tightness or penetration problem.

 

Cases of vaginismus can range from mild to severe. In some cases, vaginismus tightness may begin to cause burning, pain, or stinging during intercourse. In other cases, penetration may be difficult or completely impossible. Because of these effects, vaginismus is the main cause of unconsummated relationships. The tightness can be so restrictive that the opening to the vagina is 'closed off' altogether and the man is unable to insert his penis. The pain of vaginismus ends when the sexual attempt stops, and usually intercourse must be halted due to pain or discomfort (see symptoms).

Diagram of the effects of vaginismus on the pelvic floor muscles and vagina, contrasting with a body healed from vaginismus

Vaginismus Involuntary Tightness

 

In the labeled diagram, the effects of vaginismus are illustrated with the tightening of the pelvic floor muscles and the resulting tightness of the vagina. On the right, the pelvic floor is relaxed and normal intercourse is possible without pain.

 

Types of Vaginismus

Vaginismus can be experienced by women at any age or time in life. It has two major classifications; primary vaginismus and secondary vaginismus. The medical community typically uses these terms to indicate the time of onset. The labels assist the medical community and researchers in diagnosis and classification. For the individual woman, the distinction between the two types tends to be of less importance. Whether primary or secondary, both are highly treatable.

 

When a woman has never been able to have pain-free intercourse due to this muscle spasm, her condition is known as primary vaginismus. Some women with primary vaginismus are unable to wear tampons and/or complete pelvic exams. Many couples are unable to consummate their relationship due to primary vaginismus.

 

Vaginismus can also develop later in life, even after many years of pleasurable intercourse. This type of condition, known as secondary vaginismus, is usually precipitated by a medical condition, traumatic event, childbirth, surgery, or life-change (menopause). The initial pain problem may have been addressed medically, healed, or been managed, and yet the woman continues to experience ongoing troubles with sexual pain. The severity of secondary vaginismus may escalate to the level that penetration becomes very painful or impossible. Some women with secondary vaginismus may also experience difficulty with gynecological exams or tampon insertion.

See causes for more information.

Note that not all women’s situations fit neatly into these categories. For example, some women are able to tolerate years of uncomfortable intercourse with gradually increasing pain and discomfort that eventually leads to a sexless marriage later in life. Women may also experience years of intermittent difficulty with entry or movement, and have to constantly be on their guard to try to control and relax their pelvic area when it suddenly “acts up”.

Vaginismus is Treatable

Vaginismus is highly treatable and a full recovery from vaginismus is the normal outcome of treatment.

 

Successful vaginismus treatment does not require drugs, surgery, hypnosis, or any other complex invasive technique. Following a straight-forward program, typically involving dilators, pain-free and pleasurable intercourse is attainable for most couples.

Couple standing in the shallow water at a beach holding hands

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