Vaginismus involves an involuntary pelvic floor spasm that results in the inability of a woman to be vaginally penetrated, either due to the physical tension and/or pain. This spasm may occur with sex play, tampons, and pelvic examinations.

Researchers are not quite sure why vaginismus happens. Vaginismus can be triggered by psychological and physical causes, from a fear of pain during sex, or because of a dysfunctional pelvic floor.

If you already know what vaginismus is, skip straight to treatments down further.

Some women have never been able to have sex, masturbate or use tampons, and didn’t know this wasn’t normal. Young women don’t realise they have this issue until they go to do one of the above, and realise that they can’t.

Why do I have vaginismus?

If there is a physical causes of vaginismus, it is usually pelvic floor dysfunction, or inflammation caused by an infection (urinary tract infections or yeast infections) A traumatic childbirth experience, abuse, or violent sexual experience could also trigger vaginismus.

Psychological reasons for your vagina closing up involuntarily might include a leftover response to previous sexual abuse or rape, or the attempt thereof. This is not limited to it actually happening to you; you could have seen it happen to someone else. Domestic violence is also a reason your pelvic floor may tense up, which makes sense: if you are getting the crap beaten out of you, your vagina is doing you a favour.

Other less violent but no less problematic causes are issues with penetration itself. A fear of penetration may stem from a sincere fear of pain, pregnancy, infection or something else. This can be real from a past experience, or all in our heads.

If you are generally anxious, this can manifest in your vagina. Stress can bring vaginismus on, as can your feelings about sex, and importantly your sexual partner. If you are unhappy with your partner in some way, big or small, your vagina is saying what your mouth won’t, rightly or wrongly.

This applies to those of you who may have been brought up in very strict religious homes where a tight moral code is taught from childhood. There are lots of reasons for vaginismus, but it is not normal or helpful. Your tense muscles may have served a purpose at some point, but it is no longer needed.

Vaginismus severity and classifications

Primary vaginismus refers to women who have never been able to put anything in their vaginas.

Then we have degrees of vaginismus.

Fourth degree vaginismus means you will avoid being examined by tightly closing your thighs, squeezing your butt cheeks together and backing away from your examiner.

Third degree vaginismus means you will just raise your butt and squeeze to avoid being examined.

Second degree vaginismus results in pelvic floor spasm at attempted examination, and the spasm stays throughout your pelvis, even if you are reassured.

First degree means your pelvic floor muscle will spasm, but can be relieved with reassurance.

There is also the suggestion of a fifth degree, whereby you may sweat profusely, hyperventilate, have heart palpitations, tremble, shake, vomit, experience nausea, lose consciousness, and/or want to attack your examiner. Serious business.

Secondary vaginismus refers to women who have previously been able to insert things into their vagina, but then become unable to for some reason. Menopause is often cited for this, with the drying of the vagina by the lack of oestrogen in atrophic vaginitis. Cancer treatments may also cause vaginal drying, atrophy, thickening or pain, resulting in vaginismus.

Pelvic floor dysfunction can appear during your life for a variety of reasons, and cause vaginismus unexpectedly. Vaginismus is never normal, so getting to the bottom of it is important.

Who gets vaginismus?

Vaginismus is not widespread, but is common across populations in varying degrees. A 1990 study of women at a sex therapy clinic found that there was an incidence of between 12 and 17 per cent, with another finding of 10 to 15 per cent. Reporting rates are thought to be lower than actual incidence, since a lot of women will not speak to their doctor about their symptoms, instead trying to battle on through.

Treatment successes and failures with vaginismus

Don’t let vaginismus make you feel bad about yourself. There are loads of things you can try to get rid of it without breaking the bank or your self-esteem.

Treating vaginismus is going to be a very personal journey for every woman, and every couple. It is not always caused by psychological manifestations, but it more often than not is. This is not to say ‘it’s all in your head’, because the reasons are real, not made up. Vaginismus can be caused by physical issues, so they need to be thoroughly investigated with your doctor and a specialist who understands this condition.

Talk to your doctor about your options, but don’t just take their word for it.

It is important to first eliminate structural and physical conditions. If those elements come back as a negative, get a second opinion from a specialist pelvic pain expert or pelvic physiotherapist. If everything comes back normal, investigate psychological causes if it seems relevant.

First things first, get a proper diagnosis

You need to be diagnosed, which mostly means other more serious causes of your pain need to be eliminated. When you have a correct diagnosis, you can start working on treatments.

Visit a pelvic physiotherapist

Pelvic physios are marvellous practitioners, who see the weirdest and hardest vagina cases. Vaginal pain and dysfunction are a huge part of their area of expertise. Check up your local area for a pelvic physiotherapist or get a referral from your doctor.

Systematic desensitisation

Systematic desensitisation is a method used which has a 90 per cent success rate, though this doesn’t mean you are going to like being penetrated; it just means you will probably be able to be penetrated. Quite a difference. Obviously the goal is to both be able to be penetrated and to enjoy it when the time comes.

Vaginal Acceptance Trainers

There are some interesting devices such as the Vaginal Acceptance Trainers. Despite the name, these devices are now ergonomic and flexible, so they don’t actually force the vagina open, but mould to it. These devices help with a fear of penetration, though their effectiveness is up for debate.

Visit an osteopath who specialises in the pelvis/pelvic disorders

There may be something structurally that is causing the tension, so go and visit an experienced osteopath (preferably one who specialises in pelvic dysfunction) and see what they can discover. They will poke and prod you, but probably not in the vagina! The osteopath will find out how you use your muscles and skeleton, and what is pulling on what to do which movement.

Get a yoni massage

Yoni massage is a vaginal massage, which sounds weird, but is actually fantastic – if the therapist can get into your vagina at all, which is the first issue you will face with vaginal/pelvic massage. Your vagina is held in place by tendons and muscles and other tissue, so loosening off this tissue – like in a regular massage – can be incredibly useful. The sessions are a couple of hours, and it is a very intimate experience. Read about our naturopath’s experience here.

Having a woman yoni therapist is preferable, but not essential, and find someone with a lot of training and experience. The more vaginas they’ve had their hands in, the better, because you’ll be able to ask them questions. If anyone knows vaginas, it’s a yoni massage therapist.

Muscle-relaxant herbal medicines and drugs

There are a collection of drugs and herbal medicines that act to relax muscles. This includes Botox injections into the pelvic floor, which in some cases have relaxed and overactive pelvic floor, providing relief for months at a time, or solving the issue permanently.

Work on your mind

Are you in good emotional health? Are you self-aware and have dealt with or are dealing with any issues that stop you from living life fully and joyfully? Are you riddled with anxiety?

Dealing with your crap, managing anxiety, and making better decisions

Having your vagina closed for business is detrimental to your well-being. Don’t underestimate the power of your subconscious – any psychological problems need to be addressed. Vaginismus often forces the confrontation with past traumatic experiences, which needs to be dealt with in a kind and loving manner by a qualified, experienced therapist.

EFT and NLP

EFT (emotional freedom technique) deals with the old thoughts and stuck patterns, while NLP (neuro-linguistic programming) creates new, better ones. It’s that simple. It is better to consult a professional at first, but once you learn the techniques, you can easily do them yourself at home.

Flower essences

Flower essences are not essential oils. These magical little remedies are medicine for your emotions. Placebo or not, the process of choosing an essence is really valuable.

Hypnosis

Hypnosis works to rewire your thinking, clean out old messes, and help you focus on a brighter future where your vagina works as designed. A good hypnotherapist is a great investment, and although it doesn’t always work for everyone, it is really worth trying if you can’t figure your vaginismus out.

Relaxation techniques and meditation

Relaxation techniques and meditation can have a great effect, because they act on the brain, not on the body. The brain controls the body, most of the time. You can download or stream so many free guided meditations, there is no excuse not to try.

Strapped for cash? Try to wrangle cheaper therapy options

Schools for therapy and treatments exist (osteopaths, naturopaths, EFT/NLP therapists, etc.). Practitioners have to learn somewhere, so find those schools, and see if they have clinics or practice subjects for reduced rates or free. Students need someone to practice on, and they have experienced practitioners as tutors, so they can ask for help with cases.