Vaginismus is a condition wherein a woman’s vaginal muscles contract involuntarily when something is inserted (e.g., a penis, finger, tampon, dildo). As the vaginal muscles squeeze and spasm, the vaginal opening narrows. Penetration becomes painful; some women describe it as a searing tearing sensation. In some cases, the vaginal muscles are so contracted that penetration is impossible. One can imagine that women who have vaginismus might develop negative attitudes toward sexuality and sex and that sex becomes an unpleasant experience for all involved.

There is a great range of experiences of vaginismus; some women only experience it with certain partners, some experience it with penile penetration but not tampon insertion or gynecological exams, and still others have vaginismus in all scenarios. It’s not clear exactly why vaginismus happens, but it’s most often linked to anxiety. However, it can be difficult to determine what came first, the anxiety or vaginismus.

Anxiety is the killer of good sex. Physically, anxiety creates tension in the body. When feeling anxious, we tend to tense up in all different areas of our body (neck, stomach, shoulders, hands, etc.). Women who have vaginismus experience tension in the pubococcygeus (PC) muscle during sex. To locate this muscle, try starting and stopping urine flow next time you pee; that’s it. A clenched PC muscle makes penetration painful or impossible. In addition to affecting our bodies, anxiety impacts our thoughts. Anxious negative thoughts are not conducive to good sex. Women who experience Vaginismus might have thoughts such as “Sex is scary”; “My partner is going to be mad if I clench up”; “I’m bad at sex”; “My partner isn’t going to be understanding”. These kinds of thoughts distract from being in a relaxed yet aroused state. A woman might begin to avoid all forms of sexual and non-sexual contact to prevent the negative outcomes she’s expecting.

Women experiencing vaginismus are encouraged to focus on four main areas to address the issue of painful sexual intercourse.

1. Anxiety: Women are advised to learn strategies to decrease anxiety. These can include Cognitive Behavior Therapy (CBT) techniques like challenging negative thoughts/assumptions as well as relaxation training and stress management. A mind at ease is well suited for positive sexual experiences. Being able to call on such a state helps women to engage in intimate interactions with a sense of calm that opens the door for arousal and pleasure.

2. Relaxing the vaginal muscles: Women might begin with a breathing or visualization exercise to instill a sense of calm, then practice squeezing and releasing their PC muscle. Doing so enables them to gain awareness of the automatic tension that’s developed and allows them to experience sensation in the PC muscle with a relaxed state of mind.

3. Use of dilators: Women can learn to override the involuntary muscle contraction and desensitize vaginal muscles (and the mind!) to having something inserted into the vagina. By practicing this and becoming desensitized, a woman is preparing herself for “the real thing” and decreases the likelihood of tension and pain during sex.

4. Address relationship problems: Vaginismus is not just about the pain, it’s also about the way the pain impacts women and their partner(s). You might notice increased frustration and irritation in your couple resulting form the stress caused by the problem of vaginismus. Partners can benefit from learning to support each other and work as a team in addressing the problem. You might work on improving communication and increasing a sense of connection. In doing so, a couple may experience a shift in the negative cycle of avoidance of intimacy and rediscover pleasure.

Vaginismus is associated with not only sexual pain, but emotional pain as well. It impacts not only the women who has the condition, but her intimate partner(s). The good news is that vagnismus is a highly treatable condition; women and their partners can rediscover pleasure, excitement, arousal, and satisfaction in the bedroom.

If you or someone you know could benefit from talking to one of our clinicians about overcoming pain during sex and reviving sexual pleasure, we are here to help. Call us at 514-223-5327 to set up an appointment.

Written by: Dr. Andrea Guschlbauer, Ph.D., OPQ., Psychologist.