Vaginismus

Vaginismus causes the muscles around the vagina to tighten involuntarily. This can cause some pain and discomfort.

Vaginismus can occur whether you have had sex or not. Vaginismus usually occurs when the genital area is touched. This can be before sexual intercourse, before trying to insert a tampon, or during a gynaecological examination, for example.

What are the causes of vaginismus?

There are several possible causes of vaginismus. These include physical and psychological factors, such as:

• trauma during childbirth
• medical conditions like recurrent UTIs, yeast infections (thrush), chronic pain syndromes, endometriosis
• rape, sexual abuse or assault in the past
• a painful examination in the past
• unpleasant sexual intercourse
• fear of penetration or pain
• fear of getting pregnant

How is vaginismus treated?

There are a range of treatment options for vaginismus. See a doctor you can talk to openly. Your doctor will usually try to rule out any underlying physical conditions that may contribute to vaginismus.

Your doctor may also refer you to other health professionals, such as a physiotherapist, psychologist or sexual health therapist.

Pelvic flood therapy

For some women, seeing a physiotherapist who specialises in pelvic floor exercises may help. This treatment usually involves learning how to identify and relax your pelvic floor muscles using trigger point massage and vaginal trainers or dilators.

Counselling

Counselling can help you better understand your body. Counselling can also help you to work through any psychological issues and help with feeling more relaxed.

Self-care

A number of self-care techniques can help treat vaginismus.

Get to know your body. Have some time to yourself to explore your body and what feels good for you. Make sure you are relaxed, and start feeling yourself around the genital area.

Get used to what it feels like in and around the outer part of your vagina (the vulva) before trying to penetrate yourself. Once you are comfortable and relaxed with that, try inserting your finger gently inside your vagina. It may take days or weeks to get to a stage where you feel comfortable enough to do this. Once you can do this, feel around inside your vagina with your finger, pushing further in very gently.

You may want to try inserting a lubricated tampon instead. Use the same method, making sure you’re calm and relaxed before inserting anything.

If you have a sexual partner, you may want to ask them to touch your genitals gently, to try to get used to them being around your vagina. Again, this will probably take time before you feel comfortable enough to be penetrated with a finger.

When you reach a stage where you want to try sexual intercourse, take things slowly and don’t rush anything.

If these methods do not help, contact your doctor who may be able to refer you to a sexual health specialist.

If you are in pain, get advice on medicines you can take.