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Vaginismus

(Psychogenic Vaginismus)

Definition

Vaginismus is an uncontrollable and painful spasm of the muscles that surround the vagina. It happens when something is about to be put into the vagina, like a tampon, penis, or medical device.

Vagina
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Causes

Vaginismus is often a response to past sexual trauma or other painful events. In some women, the cause is not clear.

Risk Factors

Things that may raise the risk of this problem are:

  • History of sexual trauma
  • History of painful events, such as infection, surgery, or childbirth
  • Fear or lack of interest in sex
  • Painful first intercourse
  • Relationship problems

Symptoms

The main problem is not being able to have sex without pain. Some women may also have pain during pelvic exams or when inserting a tampon.

Diagnosis

The doctor will ask about your symptoms and health history. A physical and pelvic exam will be done. This is often enough to make the diagnosis.

Treatment

The cause will need to be treated. The goal is to ease spasms. Choices are:

  • Learning about sex organs and how they work
  • Mental health counseling to learn how to challenge negative thoughts
  • Vaginal dilation exercises that use a woman's fingers or plastic dilators to stretch the vagina
  • Kegel exercises to improve control over the vaginal muscles

Prevention

There are no known guidelines to prevent this health problem.

RESOURCES:

American Congress of Obstetricians and Gynecologists
http://www.acog.org

Family Doctor—American Academy of Family Physicians
http://familydoctor.org

CANADIAN RESOURCES:

Sex Information and Education Council of Canada
http://www.sieccan.org

Sexuality and U—The Society of Obstetricians and Gynaecologists of Canada
http://www.sexualityandu.ca

REFERENCES:

Crowley T, Goldmeier D, et al. Diagnosing and managing vaginismus. BMJ. 2009 Jun 18;338:b2284, commentary can be found in BMJ 2009 Aug 11;339:b3267.

Female sexual dysfunction. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/female-sexual-dysfunction. Accessed February 23, 2021.

Vaginismus. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/diseases/15723-vaginismus. Accessed February 23, 2021.

Vaginismus. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/gynecology-and-obstetrics/sexual-dysfunction-in-women/vaginismus?query=Vaginismus. Accessed February 23, 2021.

Last reviewed December 2020 by EBSCO Medical Review Board Beverly Siegal, MD, FACOG  Last Updated: 2/23/2021