Before we get into what vaginismus is, we want to share a story of Lina. Perhaps her story will sound similar to yours.
Lina is a second generation Chinese based in the UK and raised in a traditional, conservative household. Her parents had always emphasized that sex was reserved for marriage. In her family, physical closeness was hardly discussed, and topics like sexual education were considered taboo. Lina internalized the message that sex was something to be approached with caution or even fear.
For years, she didn't think much about it. She dated, she had sex, but never enjoyed sex because it hurts every time she attempted penetrative sex with her boyfriend. Every time they attempted penetrative sex, she felt her muscles involuntarily tighten, making penetration painful and impossible. Interestingly, when she got engaged at 28, the night of her engagement changed everything. Her pain went away.
She ended up speaking to someone and realized what she experienced was vaginismus. Her cultural upbringing and parents have instilled so much fear in her that lead to her condition of vaginismus.
What is Vaginismus?
Vaginismus is a condition where the muscles surrounding the vagina contract involuntarily when penetration is attempted, making it difficult or even impossible to have sexual intercourse, undergo a gynecological exam, or even insert a tampon. This condition can lead to significant physical discomfort and emotional distress. It can affect women of any age, culture, or sexual background, but conservative or traditional upbringings, like Lina's, may increase the likelihood due to anxiety or shame around sex.
Vaginismus is often classified into two types:
- Primary vaginismus: This is when a woman has never been able to have penetrative sex due to involuntary muscle contractions.
- Secondary vaginismus: This occurs later in life after the woman has previously had pain-free penetrative sex but then starts experiencing involuntary muscle spasms.
Physically, the muscles in the pelvic floor around the vaginal opening tighten in response to a perceived threat, blocking penetration. While the tightening itself is involuntary, it’s often tied to deeper psychological roots—typically fear, anxiety, or trauma related to sex or intimacy.
How Many Women Are Affected by Vaginismus?
Vaginismus is more common than many people realize, affecting an estimated 1-7% of women globally. In the U.S, the number ranges from 5-17%, 20% in Egypt, and up to 55.5% in India. However, this number might be underreported, as many women may feel embarrassed or reluctant to talk about it, just like Lina.
Factors like upbringing, cultural values, or prior sexual trauma often play a significant role in triggering vaginismus. Studies show that women from conservative backgrounds or cultures that stigmatize sex are more likely to develop this condition.
Causes of Vaginismus
Vaginismus doesn’t have one singular cause but is instead influenced by a mix of psychological and physical factors. Common causes include:
- Fear or Anxiety About Sex: Often stemming from a lack of sexual education or a strict upbringing where sex is viewed as dangerous or immoral.
- Past Sexual Trauma: For some women, past experiences of sexual assault or abuse can lead to vaginismus as the body’s defense mechanism.
- Negative Body Image: Cultural or personal shame about the body can make women hyper-conscious and uncomfortable with sexual intimacy.
- Pain During Intercourse (Dyspareunia): Women who have previously experienced painful sex may develop anxiety about it, which can lead to vaginismus.
- Medical Conditions: Conditions like endometriosis or pelvic inflammatory disease (PID) that cause pelvic pain can sometimes lead to vaginismus as the body becomes conditioned to expect discomfort.
How to Overcome Vaginismus: Solutions and Exercises
Overcoming vaginismus requires patience, emotional support, and in many cases, professional guidance. Here are some of the most effective treatments for vaginismus:
- Pelvic Floor Therapy: A licensed physical therapist who specializes in pelvic health can help a woman learn how to control and relax her pelvic muscles. This therapy often involves biofeedback, where women can see real-time information about their muscle tension, allowing them to learn how to relax.
- Kegel Exercises: While Kegels are typically recommended to strengthen the pelvic floor, in the case of vaginismus, the focus is on learning to relax those muscles. Practicing releasing the pelvic floor can help women gain control over the involuntary contractions that cause vaginismus.
- Dilator Therapy: Vaginal dilators are smooth, tampon-shaped tools of increasing sizes that a woman can insert into the vagina to gradually desensitize and stretch the vaginal muscles. These dilators, used in conjunction with relaxation exercises, help train the body to accept penetration without pain. Some women indicated that by adding clitoral stimulation to dilator therapy helps to increase the positive impact on the ability to progress with vaginal dilator treatment.
- Cognitive Behavioral Therapy (CBT): Many women with vaginismus benefit from talking with a therapist, particularly one trained in sex therapy. CBT can help women reframe negative associations with sex and develop healthier attitudes toward intimacy. This is especially important for women with deep-seated anxiety or trauma related to sex.
- Mindfulness and Relaxation Techniques: Breathing exercises, meditation, and progressive muscle relaxation can help reduce anxiety and stress. Learning how to shift from a fear-based response to a more relaxed state can gradually help a woman overcome the involuntary muscle spasms of vaginismus.
- Couples Therapy: It’s essential to include a partner in the healing process. Couples therapy can help both partners communicate better, understand the condition, and work together to rebuild intimacy without pressure.
Reclaiming Control Over Your Body
For women like Lina, overcoming vaginismus is not just about resolving physical discomfort but about reclaiming control over one’s body and sexuality. A blend of physical exercises like pelvic floor therapy, emotional support through counseling, and self-acceptance can help women move beyond vaginismus and enjoy healthy, pain-free intimacy.
Remember, vaginismus is treatable, and with the right approach, every woman can achieve a fulfilling sexual and emotional life. If you or someone you know is struggling with this condition, know that you are not alone and that help is available. With the proper guidance and a supportive environment, overcoming vaginismus is entirely possible.