Vaginismus: painful sex and social stigma

What is vaginismus?

Vaginismus is a condition where the vagina tightens up when you try to put something inside it. It is an involuntary action that happens automatically during vaginal penetration. According to the NHS, it can occur when you have sexual intercourse or try to use a tampon, and can cause pain.

It's hard to know exactly how many women experience vaginismus, but pain during sex is very common. A survey in the British Journal of Obstetrics and Gynaecology found that nearly one in ten British women experience some kind of pain whenever they have sex. According to the American College of Obstetricians and Gynaecologists, 75% of women will experience painful sex some time during their life.

Vaginismus often causes emotional distress. Women can develop vaginismus at any time, even if they have previously had sex without any issues. It doesn't mean that there's something 'wrong' with you, that you can't be aroused or that you do not find your partner attractive. There is no cure for vaginismus, but there are several ways to help reduce symptoms.

How does vaginismus impact the body?

People who suffer from vaginismus do not have any control over the tightening of the vaginal muscles, which spasm and contract by themselves. The friction then caused by inserting something into the vagina can cause pain or a stinging sensation.

If you experience these symptoms, it's important to see your doctor. This will allow them to rule out other issues such as STIs or pelvic inflammatory disease, which have can sometimes have similar symptoms to vaginismus. It's likely they will be able to diagnose a case of vaginismus easily, without needing to perform an internal examination. Vaginismus can have a negative impact on relationships between couples, as it makes it difficult to have sex without pain, and can even make penetration impossible. Sometimes women feel stuck in a vicious cycle – experiencing pain makes them feel nervous to have sex, which in turn makes having sex more painful, reinforcing the link between the two. Without intimacy, relationships can become strained or even break down. This in turn can have a detrimental effect on mental health, and those dealing with vaginosis often experience feelings of isolation. Vaginismus also makes using tampons and menstrual cups uncomfortable or impossible. This means women are limited to using external protection during their periods, which can impact their ability to do certain activities – for example, swimming.

How does vaginismus impact daily life?

Vaginismus can have a negative impact on relationships between couples, as it makes it difficult to have sex without pain, and can even make penetration impossible. Sometimes women feel stuck in a vicious cycle – experiencing pain makes them feel nervous to have sex, which in turn makes having sex more painful, reinforcing the link between the two.

Without intimacy, relationships can become strained or even break down. This in turn can have a detrimental effect on mental health, and those dealing with vaginosis often experience feelings of isolation.

Vaginismus also makes using tampons and menstrual cups uncomfortable or impossible. This means women are limited to using external protection during their periods, which can impact their ability to do certain activities – for example, swimming.

Why is vaginismus misunderstood?

As with many health issues specific to women, vaginismus is poorly understood. Doctors do not know exactly what causes it, although theories include negative sexual experiences in the past, and fears surrounding penetration. It likely varies from person to person, and several factors could be behind one person's condition.

Like many health issues specific to women, vaginismus can be seen as socially unacceptable to discuss publicly. According to the Better for Women report by the Royal College of Obstetricians and Gynaecologists, 24% of women feel unable to seek care due to embarrassment about their condition, while 15% of women feel judged when asking for help.

However, the less these conditions are talked about, the more easily misinformation is spread. This can cause a delay in people seeking help for intimate issues, making them worse in the long run. It also means women's partners are less likely to understand the situation.

Through open communication and a reduction in social stigma, people will find it easier to access the information they need about conditions like vaginismus. With better education, they will feel confident to approach their medical professionals and find a treatment that works for them.

How is vaginismus treated?

Unlike with male sexual disorders, such as erectile dysfunction, there is no pill that can solve vaginismus. Many Consultants choose to treat vaginismus and other gynaecological disorders using a holistic approach.

Holistic methods treat the body as a whole and appreciate that each part is connected. Holistic methods also take into account the fact that everyone experiences these conditions differently, and effects the mind can have on the body.

Physiotherapy and pelvic floor muscle exercises are often a key part of treatment for vaginismus. They involve engaging and squeezing the vaginal muscles, to help increase feelings of control and build strength. Your doctor may also give you objects called vaginal trainers to help with vaginal dilation and get you used to penetration.

Relaxation techniques are also important in treating vaginismus. Mindfulness and breathing techniques can make you feel calmer and reduce the tension in your vaginal muscles.

Talking therapy might be recommended to help you explore the possible causes of vaginismus. It can help you feel more confident and comfortable with intimacy, which in turn can make having sex physically easier and reduce the symptoms associated with vaginismus.

Vaginismus is rarely caused by an anatomical issue with the vagina, so surgery is rarely required. Physical and psychological treatment can often reduce the symptoms and allow you to have a healthy, enjoyable and pain-free sex life.

If you are struggling with symptoms of a gynaecological condition and would like to speak with one of our specialists, then you can book an appointment online or call our team to receive fast access to treatment.