Vaginismus is not just a word you might stumble over; it's a condition that affects people in ways they might never have expected.

In simple terms, vaginismus is when the muscles around the vagina involuntarily tighten up, making certain activities, like penetrative sex, unexpectedly difficult or painful.

Today, we're not just going to talk about the facts of vaginismus; we're on a mission to unravel the mystery of this condition, offer insights into why it happens, and provide advice on how people can manage it to live a pain-free sex life.

If you think you’re experiencing vaginismus, it’s important to seek help. Forget feeling embarrassed (Over 50% of us have vaginas— it should not be a big deal to talk about them).  Let’s break down walls, swap stories, and foster a supportive community where anything and everything can be discussed. Let’s get started. 

What is Vaginismus?

Vaginismus is like the body's involuntary "no entry" sign. It occurs when the muscles around the vagina contract or spasm, making penetration painful or even impossible. This isn't a conscious decision; it's an automatic response, sometimes triggered by the fear of pain associated with penetration.

Common signs of vaginismus include:

• Difficulties with vaginal penetration during sex
• Burning or stinging during penetrative sex 
• Difficulties inserting a tampon/sex toys/ etc. 

Types of Vaginismus

• Primary Vaginismus: Imagine going to open a door, and it's unexpectedly locked. Primary vaginismus is somewhat similar — it’s when these involuntary muscle contractions mean that pain-free vaginal penetration has never been possible. ‍
• Secondary Vaginismus: Secondary vaginismus, on the other hand, enters the scene after a period of comfortable and pain-free penetration. It's like that door that was open for a while suddenly becoming stubbornly jammed. Secondary vaginismus can be triggered by various factors, such as trauma, medical conditions, or even certain life changes.

How Common is Vaginismus?

Even though vaginismus often flies under the radar, it’s actually pretty common. It can affect women and individuals assigned female at birth (AFAB) of any age, background, or sexual history.

In clinical settings, anywhere between 5% to 17% of people with a vagina are thought to struggle with vaginismus. However, it’s hard to say exactly how many of us are out there dealing with this problem, as, unfortunately, many women aren’t comfortable discussing vaginismus with their doctor (or anyone for that matter).

Remember: it’s always okay to say to your doctor, gyno, or sexologist:  “Hey, I can’t put things in my vagina without it hurting — I need help”. In fact, we recommend it!

What Causes Vaginismus?

While the symptoms of vaginismus are felt physically, the causes of this condition are more than skin (or vagina) deep.

To get to the root of this problem, you may have to have an honest conversation — or several — with yourself, your partner/s, and healthcare professionals to uncover your personal factors that contribute to this involuntary vaginal response. 

‍Remember: using the right words for your body matters! Afterall, you should be an expert! When we speak about vaginas — we’re referring to the internal canal. The vulva, alternatives, refers to the external genitalia, including the labia, clitoris, and vaginal opening. 

Psychological causes of vaginismus 

If you’re trying to get intimate but your vagina has slammed closed tighter than a vault in a bank, the cause may be a complex mix of mental and physical factors. 

• Anxiety and Fear: The idea of penetration can cause anxiety and fear in some people and may trigger the muscles to tighten involuntarily. Past negative experiences, cultural taboos, or expectations about sex can all play a role too.
• Past Trauma and Abuse: It’s seriously unfair, but survivors of sexual abuse or those with a history of traumatic experiences may develop vaginismus as a protective response. The body, trying to take care of itself (in its own way), tightens up vaginal muscles as a way to shield itself from potential harm.

Physical causes of vaginismus

• Infections and Medical Conditions: Infections, such as yeast infections or urinary tract infections, can lead to discomfort and pain during penetration, contributing to vaginismus. Additionally, certain medical conditions, like endometriosis or pelvic inflammatory disease, can play a role in the development of this condition.
  
• Pelvic Floor Dysfunction: Picture the pelvic floor as a complex network of muscles, nerves, and connective tissues. Dysfunction in this area can disrupt the delicate balance, causing the muscles to contract excessively. This dysfunction may result from childbirth, surgery, or other factors affecting the pelvic region.

In short, vaginismus can be a mixed bag (and not the fun kind). Understanding the interplay of psychological and physical factors is an important part of coming to terms with vaginismus and finding the right treatment.

Just like vaginas themselves, the experience and cause of vaginismus can be unique to each person. The factors leading to vaginismus can be nuanced with a unique combination of issues contributing to each individual's experience of the condition.

Is vaginismus the same as dyspareunia (painful sex)? ‍

Think of dyspareunia as the painful “cousin condition” of vaginismus. While these two conditions were previously thought of as separate, the latest Diagnostic and Statistical Manual of Mental Disorders (DSM)  has joined vaginismus and dyspareunia (painful sex) under joint subcategory of (sh*tty) sexual pain disorders called “genito-pelvic pain/penetration disorders” (GPPD).

While people with vaginismus and dyspareunia will both experience pain during penetration, people with vaginismus will also experience difficulties achieving penetration due to muscle contractions. Symptoms of GPPD include pain itself and fear and anxiety of vaginal pain.

How do I know if I have vaginismus?

If you’ve tried to have penetrative sex (or even just tried, and failed, to use a vibrator internally) and noticed a big “do not enter” sign on your vagina — then you might be dealing with vaginismus.

Vaginismus shows up in both how you feel and what you feel physically, so catching onto these hints is key to getting a handle on things and finding some understanding and support.

‍Vaginismus symptoms include:

• Pain During Penetration: The most apparent sign of vaginismus is pain during attempts at penetration, such as during sexual intercourse or even the insertion of tampons. This pain is not just discomfort; it can range from a mild twinge to a severe, burning sensation.
• Muscle Tightness or Contraction: Vaginismus often involves involuntary muscle contractions in the pelvic floor, leading to tightness.
  
• Difficulty or Inability to Insert Objects: Besides pain, people with vaginismus may experience difficulty or an inability to insert anything into the vagina, including fingers or medical instruments.
• ‍Anxiety and Fear of Intimacy: Vaginismus often brings a heightened sense of anxiety and fear regarding intimacy. The anticipation of pain can create a psychological barrier where relaxation or romance goes out the window.
• ‍Impact on Mental Health and Relationships: The emotional toll of vaginismus can extend beyond the physical realm. Feelings of frustration, inadequacy, and guilt may surface, affecting mental health. Additionally, strained relationships can result from the challenges posed by vaginismus, making open communication and support crucial.

If you’ve noticed any of the above and tried to brush it off as just “one of those things” now is your chance to learn more about this condition and do something about it.

How is Vaginismus Diagnosed

So, you suspect vaginismus might be playing a role in your or someone else's life. What's the next step? (don’t worry, it’s nothing frightening!).

A gynaecologist, urologist, or sexual health specialist can conduct an examination, discuss your symptoms, medical history, and explore potential contributing factors. Remember: you are in control of what YOU are comfortable with. If you don’t want an internal examination, that's A-OK. You can still talk to the doctor about your symptoms and figure things out from there.

If you decide to have a diagnostic procedure, such as a pelvic exam, they may be able to rule out other conditions. Your doctor may also order imaging tests, or consultations with specialists. Throw any fears of embarrassment out the window, as there's no such thing as TMI when it comes to discussing sexual health with doctors. Open and honest discussions are key to an accurate diagnosis.

If you're based in Australia and are looking for a Vaginismus diagnosis, consider checking out Hazel. We’re Australia's first interdisciplinary online clinic dedicated to female pain. Our female doctors and sexologists are here to help you manage vaginismus (and we’re 100% stigma-free).  

Vaginismus Treatment Options

Just because vaginismus feels like doors slamming shut doesn’t mean you can’t figure out a way to get things open and comfortable again. There are many effective approaches to managing and soothing the challenges posed by vaginismus.

Psychological Treatments for Vaginismus 

Counselling and Therapy: To help what’s going on below, you might want to help what’s going on up top. Engaging counselling or therapy sessions can be helpful. A skilled professional can help guide you in addressing the psychological aspects of vaginismus, and navigate your fears, anxieties, and emotional barriers.‍

Cognitive-Behavioral Therapy (CBT): CBT isn't just for rerouting negative thoughts—it's a powerful tool for vaginas too! By identifying and modifying thought patterns and behaviours, individuals may be able to reshape their perceptions and reactions to intimacy, fostering a more positive experience.

Medical Treatments for Vaginismus 

Pelvic Floor Physical Therapy: Enter the heroes of the pelvic floor—physical therapists specialised in pelvic health. Through targeted exercises, relaxation techniques, and biofeedback, individuals may regain control and ease tension in the pelvic muscles, addressing both the physical and psychological components of vaginismus.

Medications: while not every solution comes in a bottle or a pill form, in some cases, healthcare providers may recommend medications (such as benzodiazepines, antidepressants or botulinum toxin injections) to alleviate pain or anxiety associated with vaginismus.

At-Home Treatments for Vaginismus 

Dilator Therapy: Think of dilators as gentle guides on the road to recovery! Gradually increasing in size, dilators may help individuals desensitise and stretch the vaginal muscles, making penetration more comfortable over time.‍

Mindfulness and Relaxation Techniques: Breathe in, Breathe out! Incorporating mindfulness practices and relaxation techniques can help manage the anxiety and tension associated with vaginismus. Deep breathing exercises, meditation, and guided imagery are tools that promote a sense of calm and control.

Remember what we said about vaginismus being a mixed bag? Well, that’s exactly why the key to effective treatment often lies in having a combination of the above treatments tailored to your specific needs.

Remember, there's no one-size-fits-all solution (especially when it comes to vaginas), and progress may take time. Patience, open communication with healthcare providers, and a supportive network can make a significant difference in the journey to overcoming vaginismus.

Talking about Vaginismus with your partner (or partners) 

Let’s get one thing straight, intimacy isn't solely defined by opening up physically to a partner (ie penetration) It’s about opening up emotionally! Navigating vaginismus with your partner (or partners) is a bit like choreographing a dance – it requires coordination, communication, and a shared rhythm.

Some helpful tips on how to turn this conversation into a smooth and empowering experience:

1. Open Up:

Get real. Seriously. No holding back. Start by laying it all out—your feelings and concerns about vaginismus. Kick off with "I feel..." statements, making sure the conversation revolves around your emotions. It's the first step to tag-teaming this challenge together.

2. Learn as a team:

Share your knowledge and then dive into discovery mode together. Turn this into a dynamic duo mission – Vaginismus 101. Consider it your crash course in understanding what's going on. Armed with knowledge, you'll be better equipped to face and conquer this challenge together.

‍3. Seek out the Pros:

Pitch the idea of seeking professional guidance as a positive leap forward. Whether it's from a healthcare provider or a sex therapist, present it as a supportive move to boost your intimacy game. It's like having a coach to guide you through the playbook of partnership.

4. Get an Emotional Boost:

Explore activities that amplify emotional closeness. From cosy cuddles to passionate kisses, venture into non-penetrative forms of sexual expression. It's not just about addressing challenges; it's about nurturing the emotional connection that makes your partnership thrive.

Finding help for Vaginismus with Hazel

If you're in Australia and grappling with vaginismus, Hazel can provide compassionate and stigma-free assistance. As Australia's first interdisciplinary online clinic dedicated to female pain, our team of experienced female doctors and sexologists can help you learn to manage vaginismus and achieve better sex (and more comfortable penetration).

We understand the unique nature of each person's experience with vaginismus and offer personalised treatment plans tailored to your specific needs. Our approach involves open communication, ensuring you feel supported throughout your journey.

‍Reach out today to start your path towards healing and a fulfilling, pain-free sex life.‍

The Wrap Up

Imagine your body clamping shut and saying no entry, even to your loving partner. This is the reality of vaginismus—where involuntary muscle tightness around the vagina causes pain and prevents penetration.

But fear not, there are ways to navigate through this. Treatments for vaginismus are like a toolkit, offering various approaches to ease the challenges. From counselling and therapy to physical treatments like pelvic floor therapy and medications, and even at-home practices such as dilator therapy and mindfulness techniques—each tool plays a role in unlocking comfort and joy in intimate moments. It's about finding what works best for you.

For those with vaginismus, Hazel's got your back. We offer friendly and personalised support to help you manage vaginismus and get back to a more comfortable and joyful sex life. It's all about taking a positive step towards feeling good and connecting intimately.

Vaginismus FAQs

How to fix vaginismus?

There's no real quick fix for vaginismus. Navigating through vaginismus is like crafting a personalised plan for comfort and joy in your intimate journey. While many women find relief, it’s less of a “quick fix” and more of a team effort: counselling and therapy are like your emotional cheerleaders, while medical treatments and at-home practices, like dilator therapy and mindfulness techniques, can help you relax muscle tension.

Try not to push yourself to heal overnight, but rather think of it as a unique adventure, filled with self-discovery and open communication, leading to the ultimate destination—a happy and pain-free intimate life tailored just for you.

Why is my vagina so tight?

Well, first things first, let's celebrate the fact that vaginas, much like people, come in all sorts of unique shapes and sizes. The sensation of tightness can vary from person to person, influenced by factors such as age, hormonal fluctuations, and even arousal levels. It's the beauty of our individuality shining through.

However, vaginal tightness might have a psychological side – stress, anxiety, or past experiences can cause pelvic floor muscles to tense up. Think of it as your body's unique response to emotional states. Alternatively, physical factors like infections, medical conditions, or pelvic floor muscle issues could be contributing. If persistent discomfort raises concern, a friendly chat with a doctor or gynaecologist can help figure out what’s happening.