Obstetrics and Gynecology

Vaginismus

Vaginismus is a condition in which the muscles around the opening of the vagina and surrounding the vagina involuntarily contract or tighten, making intercourse painful if not impossible. This vaginal tightness may cause pain, burning or discomfort when trying to have intercourse. If the muscles tighten too much, penetration is difficult. Women with vaginismus may also have trouble inserting a tampon or undergoing a pelvic exam. The muscle tightening is a reflex or involuntary spasm. In some cases women aren't even aware it is happening.

What causes vaginismus?

Vaginismus is considered a sexual disorder. Possible causes include:

  • Injuries or scars caused by childbirth or surgery
  • Sexual trauma or abuse
  • Infection
  • Irritation from douches, spermicides or condoms
  • Fear or other psychological factors

Vaginismus can occur the first time a woman attempts intercourse, or it can occur later in life after years of normal sexual functioning.

What are the symptoms of vaginismus?

Symptoms may include:

  • Vaginal pain during intercourse
  • Difficulty or inability to penetrate during intercourse
  • Difficulty inserting tampons or undergoing a pelvic exam

How is vaginismus diagnosed?

Diagnosis can typically be made through a pelvic exam. A detailed medical history and complete physical exam can help rule out other conditions.

How is vaginismus treated?

Treatment strategies combine education, counseling and physical exercises, including:

  • Physical therapy and Kegel exercises to stop vaginal muscles from contracting
  • Vaginal dilators, plastic cylinders used to stretch the vagina muscles
  • Biofeedback
  • Medications
  • Surgery, in rare instances