What is vaginismus?
Amelia Jean Hershman-Jones
Wellness
Reading time: 5 minutes
Experiencing painful sex? You’re not alone. We ask the experts to lift the lid on this often misunderstood condition; its symptoms & treatment options
Women everywhere should be able to enjoy rich and pleasurable sex lives. However, YouGov data reveals that 57% of British women who have ever been sexually active have experienced pain or discomfort during intercourse – to the point that they couldn’t enjoy themselves and/or had to stop.
There can be a variety of causes behind this, ranging from endometriosis to polycystic ovary syndrome, but it seems only recently that more people are feeling comfortable speaking up about it.
In fact, singer Meghan Trainor recently opened up about her experience of painful sex and the reason behind it: vaginismus, admitting that she “thought every woman walking around was always in pain during and after sex.”
How common is vaginismus?
While it’s been estimated that around one in 10 women in the UK are impacted by painful intercourse (also known as dyspareunia), the amount of people affected by vaginismus is currently unknown. Estimates currently vary from study to study.
Reasons given by experts for this include the lack of information around the condition and embarrassment around discussing its symptoms. However, it’s thought that it may be more common than many think.
What is vaginismus?
“Vaginismus is a medical condition in which the vaginal muscles involuntarily tighten when you try to insert something into the vagina,” explains Dr Tosin Ajayi-Sotubo, aka the Mind Body Doctor, a London-based NHS and private GP.
“This can be while attempting sexual intercourse, on inserting a tampon or while having a pelvic exam. It can cause mild discomfort for some to severe pain for others.”
It’s a reaction to fear, with muscle spasms that sufferers have no control over, but what can be behind it? “There’s not always a clear cause for vaginismus but we do know that psychological factors can contribute to it, including fear of sex from past trauma or past painful experiences, and anxiety disorders.
“Physical factors can also play a role, including vaginal infections, menopause and trauma experienced during childbirth.”
Dr Tosin also highlights that there are different types of vaginismus: “Primary vaginismus is when vaginismus has always occurred and the person may have never had intercourse as a result,” explains Dr Tosin. “Secondary (or acquired) vaginismus occurs when people who previously enjoyed painless penetrative sex develop the condition.”
It’s important to know that it’s not something you should simply accept or ignore
Contrary to what many think, it doesn’t always affect arousal or the ability to enjoy other kinds of sexual contact.
And it’s important to know that it’s not something you should simply accept or ignore. “Unfortunately, like many issues relating to women’s health, there is fear, stigma and misconceptions attached to this condition,” says Dr Tosin.
“This is not only wrong but can be harmful and lead to many women not seeking help until much later, or not seeking help at all.”
What are the symptoms of vaginismus?
How do you know if you have vaginismus? The fact that symptoms and signs of vaginismus can be different for each individual can make it harder both to identify and seek help for.
“Symptoms of vaginismus range from pain or discomfort during vaginal penetration to not being able to tolerate any penetration at all, including sexual intercourse, inserting a tampon or having a pelvic exam,” begins Dr Tosin. “Vaginismus can also be associated with fear around intercourse, and decreased desires or libido,” she adds.
So when should you see a GP, Boots Online Doctor* or a sexual health clinic? “I would advise seeking help if you experience recurrent pain, burning or stinging during or attempting sex, or if you find any kind of penetration difficult, including when you insert a tampon.”
What happens at an appointment?
Dr Tosin walks us through a diagnosis. “When you see a doctor or healthcare professional, initially they’ll go through your medical and sexual history and discuss your symptoms,” she begins. You can also request to see a female doctor if you prefer.
“They’ll want to know when you first started experiencing symptoms, how it has progressed and if there are any triggers.
“Then, if you’re happy and feel comfortable, a physical exam will usually be carried out and will normally consist of a pelvic examination.
“The exam is done to check for any signs of infection, scarring or anatomical problems,” says Dr Tosin. “There are ways the doctor or healthcare professional carrying out the exam can make this more comfortable for you.” It’s also unlikely they’ll need to do an internal examination.
If your doctor thinks you have vaginismus, you may be referred to a specialist, such as a sex therapist.
The outlook for most is good and vaginismus treatments are usually successful
What treatment options are available for vaginismus?
The good news? “Vaginismus is treatable,” says Claire Brodie, women’s health physiotherapist and founder of Spring Physio.
Options range from self-help to treatments done under the guidance of specialised therapists. If you’re experiencing symptoms of vaginismus, book in with a GP who’ll be able to support you and create a plan best suited to your individual needs.
“Treating vaginismus often consists of a combined approach of psychosexual therapy and women’s health physiotherapy,” explains Claire. “Vaginal dilator therapy, under the guidance of a healthcare professional, can also be a really useful tool.
“This consists of devices of different sizes that provide graded exposure to penetration which can help to stretch the muscles. A physiotherapist can also help you learn to consciously relax the pelvic floor muscles through physiotherapy, which can reduce pain and spasm during penetration,” she adds.
As for helping address the fear aspect behind the condition: “In some instances, there can be a psychological contributor, coinciding with a trauma such as sexual assault, traumatic birth or a bad experience with a medical professional,” says Claire.
“It’s important to identify and treat any traumas alongside the physiotherapy of the muscles.”
This is where counselling or therapy to address any past traumas, anxieties or fears and reduce the involuntary contractions of the muscles comes in. “Psychosexual therapy, relaxation techniques, cognitive behavioural therapy (CBT) and sex therapy and counselling are all options,” Dr Tosin explains.
If you need a safe space to talk, you can access services such as Blueheart Online Relationship & Sex Therapy and a range of mental health resources through our Health Hub**.
Dr Tosin assures us: “The outlook for most is good and vaginismus treatments, which may be one of the above or a combination over time, are usually successful. However, the more severe the symptoms, the more difficult or the longer it may take to treat.”
It can also be helpful to know that very few cases of vaginismus require surgery and, with the right treatment, it may be possible to see improvements within a few weeks.
Self-help for vaginismus
You may prefer trying a few self-help techniques at first, to help you to get to know your own body. Though it’s also important to see a GP to check for any underlying causes.
This could involve taking a warm, relaxing bath, doing breathing exercises and touching yourself around the vaginal area, or considering products such as dilators and lube to help make sexual activity more comfortable.
Here are two options to consider:
Ann Summers My Viv Dilator Set
• Made with silicone
• Set of three
Made with silicone, this three-piece set is ergonomically designed for comfortable insertion to help with vaginal tightness. Using lubricant, try starting with the tapered end of the smallest dilator first, slowly placing it inside the vagina and keeping it in place for up to 15 minutes before building your confidence, and then progressing slowly but surely through the sizes.
Durex Naturals Water Based Extra Sensitive Lubricant Gel
• Size: 100ml
• pH-friendly
• Water-based
• Free from artificial fragrances and colours
• Compatible with natural rubber latex condoms, polyisoprene condoms and Durex sex toys
• Can be used for masturbation
Designed to help ease vaginal dryness and discomfort, this water-based lube helps provide useful slip while also being gentle on intimate skin.
