What Is Vaginismus?

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Vaginismus is a condition where the muscles around the vagina involuntarily tighten or spasm, making light touch or penetration painful or impossible for many women. Sexual intercourse, tampon insertion, a gynecological examination, or even when trying to insert a finger, tightening of this area causes pain both physically and emotionally for many women and their partners too! 

 

What Are The Types of Vaginismus?

 

Vaginismus is typically classified into two types: primary and secondary.

 

Primary Vaginismus

 

This occurs when a woman has never been able to achieve vaginal penetration due to involuntary muscle tightening. 

 

Secondary Vaginismus

 

This develops after a period of normal, pain-free vaginal penetration. A woman who once had no issues, may later begin experiencing involuntary muscle contractions that makes penetration painful or impossible.

 

What Are The Causes of Vaginismus?

 

While the exact cause of vaginismus is not always clear, it is commonly linked to emotional, psychological, trauma and or cultural factors.

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Common Contributing Factors Of Vaginismus

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Fear and Anxiety

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Anxiety around penetration, fear of pain, hymen tearing, or the size of the penis can trigger involuntary muscle responses.

 

Negative Sexual Conditioning

 

Strict or conservative cultural, religious, or sexual upbringing may create shame, guilt, and anxiety around sexual activities.

 

Past Trauma

 

History of sexual abuse or negative sexual experiences may cause vaginismus, as a subconscious protective response.

 

Medical or Life Events

 

Secondary vaginismus can occur after childbirth, menopause, pelvic surgery, hormonal changes or other medical events. Pain or trauma during recovery may trigger involuntary muscle spasms with future penetration attempts.

 

What Are Some Symptoms of Vaginismus?

 

Symptoms can vary and may include:

 

• Pain or burning sensation during attempted penetration (e.g. sex, tampon insertion, or exams)

• Involuntary tightening of pelvic or thigh muscles during penetration

• Anxiety or fear about penetration or pelvic exams

• Difficulty using tampons or undergoing gynecological exams

• Painful or unsuccessful intercourse, often described by partners as “hitting a wall”

• Reduced sexual desire due to anticipated pain or frustration

• Emotional distress, such as embarrassment, shame, or feeling broken

 

Why Choose Vaginismus Treatment at PhysioMatters?

 

You don’t need to face Vaginismus alone. Many women recover successfully with the help of a Women's Health Physiotherapist, who is trained to guide you through both the physical and emotional aspects of recovery.

 

Physiotherapy Treatment for Vaginismus

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Physiotherapy focuses on regaining control of your pelvic floor muscles, reducing discomfort, and addressing any psychological triggers linked to vaginal penetration. Treatment includes:

 

• Patient Education: Understanding your condition empowers you to take control of your body.

• Pelvic Floor Muscle Training: Guided exercises help you relax and coordinate pelvic muscles, reducing involuntary tightening.

• Breathing and Relaxation Techniques: Techniques to reduce anxiety and muscle spasms in the pelvic area.

• Manual Therapy: To treatments to release tight pelvic muscles, reduce discomfort, and improve tissue mobility.

• Desensitisation and Dilator Training: Using vaginal dilators in a structured, step-by-step manner,, you’ll gradually become more comfortable with vaginal insertion.

• Real-Time Ultrasound (RTUS)

 

Multidisciplinary Support

 

While physiotherapy is the core of treatment, additional options can support recovery:

 

• Sex Therapy: Psychosexual therapy addresses the emotional aspects of vaginismus, helping with fears or past trauma.

• Topical Creams: Medication to alleviate discomfort and reduce sensitivity.

• Botulinum (Botox) Injections: In some cases, Botox may be used to relax overactive pelvic muscles, easing the pain of penetration.​​​​​​​​​