Vaginismus
The involuntary contraction of muscles which surround the vagina and those of the inner thigh with any kind of attempted vaginal penetration is vaginismus. This makes vaginal tampon / vaginal cup insertion, penile penetration or vaginal speculum gynaecological examination difficult.
Some common questions related to vaginismus is answered here.
- What causes vaginismus?
The most common reason for vaginismus is the anxiety or fear of vaginal intercourse. It is a phobic response which happens involuntarily. Most of the time, the woman wants to allow penetration. However, the muscle contraction happening involuntarily does not permit it.
A history of abuse may be elicited in some women. It is not always a pre-requisite. Some women may experience severe forms where any kind of penetration is impossible, whereas some women may experience milder forms.
The other causes of vaginal pain syndrome such as vaginal infections, dryness, vulvodynia or endometriosis should be ruled out. - How common is vaginismus?
Studies have shown that 1-6% of women are diagnosed with vaginismus. However, it is believed that most cases are unreported as women do not present with this problem.
Painful vaginal intercourse in women is seen in 20% of women.
Some women presenting with infertility, on evaluation, are finally diagnosed with vaginismus. The male partner may present with secondary erectile dysfunction, as a result of anxiety. - Can vaginismus be cured?
The short answer is, yes. However, it may take time in some women. Adequate counselling and education of the woman and her partner go a long way in managing this condition. The woman is reassured that the anatomy is normal. Vaginal dilator therapy is proven to benefit. Pelvic floor exercises for relaxation can help train the muscles.
In resistant cases, psychological treatment may be advised. Botox injection into the pelvic floor muscles can relax them and decrease the severity of vaginismus. - Who is the best doctor for vaginismus treatment?
Dr Sneha J is a Gynecologist and best fertility and sexual medicine specialist. She has completed MD OBG from the top university AIIMS , Delhi and University fellowship in Fertility/ Reproductive medicine. She had further training in dealing with these conditions at the European Society of Sexual Medicine School, Budapest, Hungary.
Frequently Asked Questions
Vaginismus involves an involuntary tightening of the muscles around the vagina and inner thighs when penetration is attempted. This can happen even when a woman wants to have intercourse, so the difficulty is not simply a matter of unwillingness or lack of desire. Vaginismus treatment focuses on identifying and addressing the underlying physical and emotional factors.
Yes. The involuntary muscle contraction can make insertion of a vaginal speculum uncomfortable or difficult, just as it can affect penile penetration. If routine examinations have repeatedly been difficult because of pain or muscle tightening, a vaginismus evaluation can help identify the underlying problem.
Yes. Vaginismus can present in different ways, and the underlying fear or anxiety response may become apparent when penetration is first attempted. A specialist assessment can help distinguish vaginismus symptoms from other causes of pain or difficulty with penetration.
It can. When vaginal penetration or intercourse cannot be completed, sperm may not be deposited normally inside the vagina, which can make natural conception difficult. Some women who present for infertility evaluation may ultimately be found to have vaginismus, making vaginismus and infertility an important consideration for some couples.
Yes. Anxiety or fear of vaginal intercourse can contribute to vaginismus. The muscle contraction is involuntary, meaning a woman may consciously want penetration while her pelvic muscles respond automatically with tightening. Psychological factors in vaginismus can therefore be important during assessment and treatment.
It can sometimes affect the male partner as well. Anxiety related to unsuccessful attempts at intercourse may contribute to secondary erectile dysfunction in the partner. Addressing vaginismus and partner anxiety together can therefore be important for the couple rather than treating the woman in isolation.
Not necessarily. Difficulty with tampon and vaginal-cup insertion can be a possible manifestation of vaginismus, but other causes of discomfort or insertion difficulty can exist. A female sexual health evaluation can help determine why insertion is difficult rather than assuming the diagnosis from one symptom alone.
No. The condition can affect several situations involving vaginal penetration, including sexual intercourse, tampon or menstrual-cup insertion, and speculum examinations. This broader impact is why vaginismus care may be relevant even when pregnancy or intercourse is not the immediate concern.
A specialist consultation can be appropriate, particularly when the problem is preventing conception or has continued despite attempts to overcome it. Since vaginismus can sometimes be identified during infertility evaluation, discussing both sexual and reproductive concerns can help guide vaginismus and fertility care.
Treatment can be approached sensitively and confidentially, with the patient's comfort and consent guiding the consultation. Because vaginismus can involve both physical and emotional factors, the specialist can discuss the available vaginismus treatment options and whether involving a partner would be helpful for the individual couple.
