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 the muscles surrounding the entrance to the vagina involuntarily tighten, making penetration impossible or painfully uncomfortable. When the muscles tighten at the vaginal opening, attempts to insert anything become frustratingly difficult. Most women are unaware that the muscles are tightened when it occurs. Some clinicians use the medical term Genito-Pelvic Pain/Penetration Disorder (GPPPD) in place of Vaginismus, but we will continue to use the terms Primary and Secondary Vaginismus, describing the two manifestations of the condition:


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

Symptoms of Primary Vaginismus:

If at ‘first-time’ intercourse, full sexual penetration seems physically impossible despite repeated attempts — almost as though there is no opening where the vaginal opening is supposed to be — it indicates Primary Vaginismus in over 99% of cases. Although sometimes it may seem like there is partial penetration, typically the tip of the penis just presses into the fleshy outer vulva area, not into the vagina. Vaginismus is nearly always responsible for unconsummated marriages due to the female partner. They often mistakenly wonder if they are physically abnormal in some way; whether their vagina is too small, their hymen is blocking the opening or they have no vaginal hole at all. This is understandable, for when vaginal muscles are tightened it may seem like the opening is unusually tiny or non-existent

There are two other early symptom indicators of Primary Vaginismus that are sometimes, but not always experienced prior to intercourse attempts:

Some young women have difficulty inserting tampons, even after repeated attempts.

Some women find it very challenging to allow their physician to complete an internal vaginal exam with a speculum or finger due to a tight opening (may appear to the physician as unusually small).

Symptoms of Secondary Vaginismus:

Unexplained, ongoing sexual tightness and discomfort following a negative (usually pelvic) experience almost always indicates Secondary Vaginismus. Though there was a previous history of normal intercourse and the negative pelvic experience was resolved, the ongoing tightness, pain and discomfort eventually causes a couple to discontinue sex.

Typically this type of vaginismus is triggered by a temporary physical pelvic medical condition, trauma, or pelvic-pain issue. Examples could include a urinary tract or other pelvic infection; a difficult delivery with stitches required; age-related changes like a hormonal/lubrication reduction after menopause; rape or assault; a pause of many years between spouses; or another similar occurrence. The ongoing tightness is perplexing. Women wonder why it would continue to be difficult or impossible to have sex, even though the initial problem had healed, resolved or was fully treated.

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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