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The Curious Case of Vaginismus – When You Body Rejects Penetration

The Curious Case of Vaginismus – When You Body Rejects Penetration


Did you know that about 0.5% of women suffer from a painful condition called Vaginismus? The symptoms typically involve involuntary vaginal tensing due to the contraction of vaginal muscles, during any kind of penetrative action. This results in pain and discomfort during sexual intercourse. Spasms can also occur while inserting a tampon, menstrual cup or an internal condom. Vaginismus can make medical tests like a pelvic exam or a pap smear, difficult to go through and eventually making it hard to control your safety, sexual pleasure, and reproductive choices. Is there a way to manage vaginismus? Let’s find out all you need to know about this condition.

Vaginismus can be a physical response to some fear or insecurity – and you will have no control over these contractions. Some women face milder effects compared to others. The diagnosis of vaginismus is on the basis of symptoms. Subsequently, pelvic exams, performed gently, may be needed.

You must note that vaginismus may develop even if you do not have a painful sexual experience. It will also not affect your capability to be aroused or respond to non-penetrative sexual acts. There are different treatment options involving touch and psychotherapy to help you.

Causes of Vaginismus

The causes of vaginismus are often psychological, physiological, or physical. These causes include:

  • Fear of vagina being too small for penetration
  • Anxiety disorders
  • Guilt or shame about sex
  • Painful sexual experience in the past
  • Unpleasant experience during a surgery or medical test
  • Surgical or childbirth injuries
  • Infections in the vagina, vulva, urinary tract, bladder, etc.
  • Experience of sexual abuse, trauma, or rape
  • Low sex drive due to various reasons

Diagnosis of Vaginismus

Proper diagnosis helps the doctor understand whether you are suffering from vaginismus or some other condition. Symptoms similar to those of vaginismus may be caused by vaginal atrophy, vulvar vestibulitis, etc. Symptoms that should alarm you, besides difficult penetration, are:

  • Irritation, burning, or itching in the genital
  • Painful urination
  • Redness, swelling, or soreness in the vagina
  • Unusual vaginal discharge, often with a foul smell

The diagnosis process will start by describing and explaining the above symptoms to your doctor. You will be asked when the problem occurred for the first time, how often it happens, and what seems to be the trigger. You will also have to discuss your sexual history and medical conditions.

These questions will help identify the psychological or physiological cause. You may also have to take a pelvic exam to confirm the cause. Penetrative activities are a common symptom of vaginismus. So you can discuss ways of making the exam comfortable and gentle for you.

To make things easier, you may discuss not using stirrups. You can choose to guide the medical instruments of the doctor’s hands during the insertion process to make the penetration painless. Trying different positions during the test might help. You might feel in control if you use a mirror.

It is a great idea to know the different steps of the exam. You will feel mentally relaxed and prepared when your doctor explains what they are doing or about to do as they go along. If your doctor suspects vaginismus, they will likely be gentle in the way they perform the test.

A pelvic exam can become more comfortable and painless if the doctor uses a topical numbing product on the area outside the vagina right before the test. A pelvic exam is an excellent way to rule out other possible problems. It can confirm if you have involuntary muscle tensing or spasms.

Treating and Managing Vaginismus

The symptoms of vaginismus can be managed with the help of regular therapy. It can involve psychotherapy, cognitive behavioral therapy, kegels, vaginal trainers, touch therapy, and more. Such treatment options will improve your sex life and alleviate pain during other forms of penetration.

Vaginismus treatment options include the following:

  • Psychotherapy: A form of therapy to discuss your body and sexual issues to identify what’s triggering vaginismus and overcome the problem through counselling;
  • Sex Therapy: A specialised type of psychotherapy that focuses on an individual or a couple to improve your sexual relationship and pleasure, as well as your health;
  • Cognitive Behavioral Therapy: A kind of therapy to understand the impact of your thoughts on your body and emotions to address mental health conditions;
  • Sensate Focus: A set of exercises that focus on your sensuality and sensory perceptions to help you relax and get comfortable with the idea of intimacy;
  • Topical Treatment: Application of creams with lidocaine or other compounded content on the outside of the vagina to help ease any discomfort during penetration;
  • Relaxation Techniques: A therapy process involving breathing techniques, touching exercises, and the unwinding of your mind to control vaginal muscle relaxation;
  • Pelvic Floor Exercises: A set of therapeutic exercises, also known as Kegels, involving squeezing and releasing pelvic floor muscles to gain control over vaginal muscles;
  • Vaginal Trainers: Tube-shaped devices, also known as vaginal dilators, used to stretch the vagina to train your vaginal muscles to become less sensitive to penetration.

Vaginismus can interfere with your sex life and healthy practices. But proper treatment can reduce the vaginal reflex to all penetrative activities, besides addressing fear or insecurities causing it. You will soon be able to enjoy sex – and use female condoms, menstrual cups, etc., comfortably.

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