Ever try putting in a tampon or getting intimate, but you feel like you hit a brick wall down there (ouch!)?

That burning pain or complete blockage could be vaginismus.

Don't worry, it's more common than you think, and there's good news: it's treatable!

What is vaginismus?

Vaginismus is an involuntary tightening or spasm of the vaginal muscles that makes penetration painful or impossible. It's considered a sexual pain disorder that can interfere with activities like sexual intercourse, inserting tampons, or undergoing gynecological exams.

The key characteristics of vaginismus are:

• Severe muscle tightness or contractions in the vagina that occur with attempted penetration
• Pain or inability to have vaginal penetration of any kind, even with sufficient lubrication
• The muscle spasms are involuntary and out of the person's control

Vaginismus can occur as an isolated condition or may develop secondarily due to other factors like fear, past trauma, endometriosis pain, or beliefs about sex. In many cases, the exact cause is unknown.

How do I know if I have vaginismus?

Some potential signs and symptoms that could indicate vaginismus include:

• Burning, stinging pain, or feeling tightness with attempted vaginal insertion of any kind
• Inability to insert a tampon or have sexual intercourse because it feels completely blocked
• Anticipating or fearing penetration attempts, sometimes avoiding them altogether
• Muscle spasms or squeezing sensations in the vagina during penetration attempts
• No problems with lubrication, but penetration still fails or causes pain

If you experience consistent, significant pain or an inability to have penetration despite motivation and sufficient lubrication, it's worth discussing with a gynecologist or sex therapist. They can evaluate if vaginismus or another condition is present.

Is vaginismus common?

Turns out, vaginal muscle spasms (vaginismus) are more common than you might think. Studies show anywhere from 5% to 17% of women experience this in clinical settings, making it one of the more frequent female sexual problems.

It tends to first manifest in younger women attempting their first experiences with tampon use or sexual intercourse. The condition seems to be equally prevalent across cultures, ethnicities, and socioeconomic backgrounds worldwide. Many cases likely go unreported or undiagnosed, as some women avoid discussing intimate sexual health issues.

Is vaginismus psychological?

Doctors mostly think vaginismus stems from mental blocks around sex. These blocks could be caused by past sexual trauma, abuse, strict religious or sexual values, or even anxieties.

There are a few key reasons why past sexual trauma, abuse, strict religious or cultural teachings about sex, and general anxieties can contribute to the development of vaginismus:

Past Sexual Trauma/Abuse

Trauma or abuse of a sexual nature, especially during the formative years of life, can create deep-rooted and powerful unconscious associations between the act of penetration and feelings of pain and fear. The body, in its inherent wisdom, learns to guard against penetration as a self-preservation instinct after enduring such traumatic experiences.

Survivors of abuse may develop vaginismus, a psychosomatic reaction characterized by involuntary and persistent tightening of the vaginal muscles, even in instances where the individual is not consciously processing the trauma they have endured.

Strict Religious/Cultural Beliefs

In some cultures or religious traditions, strongly conservative or taboo views surrounding sexual activity can instill a profound sense of shame or anxiety within women when it comes to any form of sexual expression. The anticipation of pain or punishment for engaging in such acts can override the body's ability to willingly relax the vaginal muscles, which is a necessary prerequisite for comfortable penetration. Viewing sex as a forbidden or "dirty" act can lead to a constant state of tension and contraction in the pelvic floor muscles, making penetration difficult or impossible.

General Anxiety/Fear

For some individuals, vaginismus may stem from generalized anxieties or fears surrounding sex, intimacy, vulnerability, or the perceived loss of control. Catastrophic thoughts, such as "It will never fit" or "It's going to hurt so much," can create an unconscious response in the body, causing the vaginal muscles to tighten involuntarily.

Overall stress and the tensing of the body during anxious states can also translate to the vaginal muscles, leading to a condition where penetration becomes a source of significant discomfort or distress.

In all these cases, the vaginal muscle spasms are an unconscious psychosomatic reaction rooted in previous traumatic experiences or deeply ingrained fears/beliefs surrounding penetrative sexual activities. Cognitive associations get created that penetration = danger/pain. Vaginismus develops as an involuntary guarding reflex by the mind/body.

But that's not always the case - some women with vaginismus haven't had any of those experiences.

What causes vaginismus?

There are multiple potential causes and risk factors for developing vaginismus:

Aside from the

Psychological Factors

• Fear or anxiety around vaginal penetration
• History of sexual abuse/trauma
• Strict cultural or religious teachings about sex
• General stress and tension

There are also

Physical Factors

• Injury or trauma to the pelvic area
• Endometriosis or other conditions causing pelvic pain
• UTIs
• Yeast infections
• Reaction after severe vaginal infection/irritation
• Childbirth injuries

In many cases, vaginismus develops from a combination of these potential causes creating a cycle of anticipatory anxiety, pain, and muscle tightening with penetration attempts.

Is vaginismus genetic or hereditary?

No, vaginismus is not considered a genetic or hereditary condition. There is no evidence that vaginismus can be passed down through family genes or genetics.

While it's possible that some women may have a lower pelvic floor muscle tone genetically that could theoretically increase susceptibility, vaginismus itself is not an inherited condition according to medical research.

The development of vaginismus has much more to do with the complex interplay of a woman's individual circumstances, psychological state, and experiences surrounding vaginal penetration. With the right therapy and treatment, the condition is very treatable regardless of genetics or family history.

Can vaginismus be cured?

Yes, vaginismus is considered a highly treatable condition. With proper technique, counseling, and patience, the majority of women can overcome vaginismus. However, it requires an active commitment to specific exercises and therapies.

What exercises will loosen down there?

There are a few different exercises and techniques that can help loosen and relax the vaginal muscles for women with vaginismus.

Here's how to treat vaginismus at home:

Pelvic Floor Stretches

• Deep breathing exercises to relax the pelvic floor muscles
• Gently pressing on the vaginal entrance or inserting a finger to stretch the opening
• Yoga poses like a happy baby or child's pose to release tension

You can check out this video here:

Vaginal Dilators

• Using graduated vaginal dilator trainers to slowly stretch the vaginal opening
• Start with the smallest size dilator and progressively work up in thickness
• Hold the dilator in place for increasing lengths of time

You can check what it is here.

Can you use fingers instead of dilators?

Research shows it doesn't matter if you use dilators or your fingers for this treatment (dilation and desensitization). Both groups improved significantly, but the dilator group had better treatment completion rates and showed greater improvement in sexual function.

Kegel Exercises

• Performing kegel exercises to better control and relax the pelvic floor
• Alternating between squeezing and fully relaxing vaginal muscles
• Reverse kegels focus on intentionally releasing pelvic floor tension

You can check out this video here:

General Relaxation Techniques

• Deep breathing from the diaphragm
• Progressive muscle relaxation routines
• Mindfulness meditation to relieve anxiety

It's best to work with a pelvic floor physical therapist who can guide these exercises properly. They can ensure good technique to relax rather than further tighten the muscles. Consistent practice over time is key for retraining the pelvic floor.

The main goal is learning to consciously release the involuntary tightness and spasms that characterize vaginismus. With the right stretching and relaxation approaches, the vaginal muscles can regain flexibility.

The key is using a multidisciplinary approach of interventions to relax the vaginal muscles, address fears or anxiety, and regain control over the pelvic floor. With persistence, most women can successfully achieve pain-free penetration.

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How to Tell Someone You're Dating You have Vaginismus

We let Couply friend Azia To give you her quick guide on talking about vaginismus while dating here.

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Vaginismus Surgery

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In some cases, surgical intervention has been proposed as a potential treatment option for vaginismus, with the aim of addressing physical obstructions or tightness that may contribute to the condition. Two specific procedures involving the hymen have been considered:

1. Hymenotomy

A hymenotomy is a surgical procedure in which an incision is made in the hymen, the thin membrane partially covering the vaginal opening. This incision creates a larger opening by disrupting or stretching the hymenal tissue. The hymen itself is not entirely removed during this procedure.

A hymenotomy may be recommended in cases where the hymen is particularly rigid or narrow, potentially contributing to the difficulty with vaginal penetration experienced in vaginismus. By increasing the size of the vaginal opening, it is believed that penetration may become more comfortable for some individuals.

2. Hymenectomy

In contrast, a hymenectomy involves the complete surgical removal of the hymen. During this procedure, the entire hymenal membrane is excised, leaving a more open and unobstructed vaginal entrance.

A hymenectomy may be considered in cases where the hymen is exceptionally thick, rigid, or imperforate (completely covering the vaginal opening), and is believed to be a significant contributing factor to the individual's vaginismus.

It's important to note that while these surgical procedures may address potential physical barriers, vaginismus is a complex condition with psychological, emotional, and muscular components.

Surgery alone is often not sufficient to fully resolve the condition, and it is generally recommended to explore non-invasive treatment options first, such as cognitive-behavioral therapy, pelvic floor physical therapy, and gradual desensitization techniques.

Any decision regarding surgical intervention for vaginismus should be made in consultation with a qualified healthcare professional who specializes in sexual health and pelvic floor disorders, ensuring a comprehensive understanding of the potential risks, benefits, and long-term implications.

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Find a Coach and Community with Dialato

We spoke with Azia To who has been raising awareness about Vaginismus for a long time on our Couply podcast.

She has built Dialto tech a community to help people go from pain to pleasure.

You can join the community for free here.

Azia is an expert and thought-leader in the Vaginismus space, we spoke to her on the Couply podcast here:

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Disclaimer: This blog post is intended for informational purposes only and should not be construed as medical advice. Please consult with a healthcare professional for diagnosis and treatment of vaginismus.

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About the Author

Sheravi Mae Galang is a Content Coordinator for the Couply app. Couply was created to help couples improve their relationships. Couply has over 300,000 words of relationship quizzes, questions, couples games, and date ideas and helps over 400,000 people. You can connect with her through email here.