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Vaginismus: symptoms, treatments, and sexual health

Have you ever tried to have penetrative sex and been unable to open up down there—or had incredible pain with any attempt at insertion? Whether this has always been the case or recently started, you may be experiencing a condition known as vaginismus. 

“Vaginismus is the inability to penetrate the vagina due to pain and spasms in the muscles of the pelvic floor, making sex unbearably painful or impossible altogether,” says Sarah Clampett, PT, DPT, Clinical Director at Origin.

Vaginismus is a fairly common condition. Clampett explains that one in six people with a vagina will experience it at some point in their lifetime. Based on when and how vaginismus presents, it falls into two categories.

Primary or Secondary Vaginismus?

“Primary vaginismus is when the pain and symptoms have always been present, while secondary vaginismus develops later from a specific event like trauma, infection, childbirth, or menopause,” says Clampett. “Women with secondary vaginismus experience pain-free sex prior to developing symptoms, which can make it especially hard to regain intimacy with a partner when sex feels off the table. However, both primary and secondary vaginismus can make developing intimacy extremely challenging, frustrating, and seemingly hopeless.” 

If this sounds familiar, you may be experiencing vaginismus. While certainly scary, it is treatable with the right information.

Here’s everything you need to know about having vaginismus. 

Vaginismus and Sex

Though penetrative sex isn’t the only indicator for vaginismus, it can make your condition very apparent. “Vaginismus may or may not affect sexual arousal. It can negatively affect your sex life if penetration or genital touch is part of your routine,” says Dr. Kameelah Phillips, OBGYN and Founder of Calla Women's Health

If a person is unaware that they have vaginismus, it can lead to an avoidance of intimate contact and strong anxiety. “Over time people can begin to make negative associations with sex and intimacy,” continues Dr. Phillips. “It can also put a strain on relationships. For partners who are unfamiliar with the condition, they can mistakenly interpret vaginismus as a physical rejection of their romantic display and may create issues with communication and intimacy.” 

As with any aspect of a relationship, honest communication with your partner is critical to ensure you both are comfortable and understand what you’re experiencing. “You can be sensual and feel pleasure with someone without being sexual,” says Clampett. “Partners should create a safe space to engage in open dialogue about which non-sexual experiences could be arousing and bring them closer together until sex is an option again.”

How to Know If You Have Vaginismus

While the symptoms of vaginismus are very apparent, to fully get a picture of what is going on, an OBGYN can confirm if that is what you’re experiencing and how to treat it.

Plus, a doctor may catch indicators you weren’t aware could be symptoms. 

“Patients often self report the inability to use a tampon, have penetration, or ‘don’t do well’ with GYN exams,” says Dr. Phillips. “Sometimes there is a triggering event that has caused the onset of this symptom and sometimes there is not. After taking your history and looking for other causes that may cause these symptoms, your doctor will then examine you.” 

Once it’s confirmed that you have vaginismus and not another underlying problem, your doctor can prescribe treatment. 

Treatment Options for Vaginismus

Fortunately, vaginismus can go away with proper treatment. 

“Sexual therapy and psychological counseling are a cornerstone of treatment,” says Dr. Phillips. “Whether done on your own or with your partner, therapy helps you explore deep inhibitions, trauma, and other triggers for vaginismus. It can also provide essential tools such as relaxation techniques, hypnosis, and internal mantras to help you work through the stress of intimate contact.”

Whether vaginismus was brought on by some sort of trauma or has created anxiety around sex, mental health therapy can play a huge part in overcoming it. 

In concurrence, physical therapy and learning about your own anatomy is recommended.

“Physical therapists that specialize in pelvic floor conditions are helpful to initiate the use of dilators and the treatment of hypertonic pelvic floor conditions,” says Dr. Phillips.

Dilators can allow you to practice penetration at your own comfort level or with the help of a partner. 

Not having control over your body to do things like have penetrative sex or even insert a tampon can be unbelievably taxing, but taking it slow and following your doctor’s recommended treatment can allow you to take back your power. 

“It is extremely important to respect the healing process and to not engage in penetrative sex before one is ready because they ‘want to get it over with,’” says Clampett. “When one feels ready to return to sex with their partner, don’t jump right back into penetration and focus on outercourse, whatever that means to you. Returning too quickly to penetrative sex can cause more pain, fear, and stress and undo the progress they worked so hard to gain.” 

This is not a condition that has to last forever.

Take things one step at a time, get to the heart of your vaginismus and, before you know it, it will be in the past. 

If you’d like to speak with a specialized physician about your sexual health concerns, you can schedule a consult today

Sarah Fielding
Sarah Fielding is a freelance writer based in New York City. Covering a range of topics with a focus on mental health and women's issues, her work has appeared at Healthline, Bustle, Business Insider, Fortune, and more. Fielding received her bachelor's in international fashion and business management from FIT, and also spent time living in Italy and Australia, writing as she traveled. She's the co-founder of Empire Coven, a space for highlighting trailblazing women across New York.