What is Vaginismus?

Vaginsmus is vaginal tightness causing discomfort, burning, pain, penetration problems, or complete inability to allow vaginal penetration. This penetration may include sexual intercourse, certain medical examinations and tampon use.

It is caused by a reflex of the pubococcygeus muscle (PC muscle). This muscle is located at the lower end of the vagina. The reflex causes the vagina to tighten abruptly and thus make any penetration impossible or very painful. A woman suffering from vaginismus cannot control the extent of the reflex reaction. The severity of the condition will vary among women. A vicious cycle is quickly established, where continued repeated efforts at penetration worsen the muscle spasm and the degree of vaginismus becomes more extreme.

What are the main causes of it?

There can be both psychological and physical reasons

Psychological problems include:

  • Fear of sexual intercourse or anticipation of pain associated with penetration
  • Anxiety or stress
  • Partner issues such as fear of losing control, distrust
  • Traumatic events such as a painful, rushed and unpleasant first sexual encounter
  • Childhood experiences such as sexual abuse

Physical problems include:

  • Medical conditions such as thrush, STDs, vulvodynia
  • Childbirth
  • Age-related changes such as vaginal dryness secondary to menopause
  • Temporary discomfort such as inadequate vaginal lubrication or inadequate foreplay


Firstly it is important to stress that this is an extremely treatable problem, with very high success rates if addressed properly. A treatment regime will be established on an individual basis as the reasons for developing the condition will vary from patient to patient. Initially we will need to establish whether the cause is psychological or physical. This is done by thorough history taking and physical examination. Those who are diagnosed as having psychological problems may be referred to a qualified counsellor if required. Often this is a problem which can be successfully managed by the woman herself, whether with the support of her partner or not.

The basis of treatment when a physical cause has been excluded is that of a series of steps which can be easily completed by the woman at her own pace in the privacy of her own home, or equally under the supervision of a qualified sexual therapist recommended by your doctor.

Below is a rough guide to the steps followed, the end result being full penetrative intercourse with no pain associated and an enjoyable experience

Step 1 – Understanding vaginismus

Step 2 – Sexual history review & treatment strategies

Step 3 – Sexual pain anatomy

Step 4 – Vaginal tightness & the role of pelvic floor muscles

Step 5 – Insertion techniques

Step 6 – Graduated vaginal insertions

Step 7 – Sensate focus & techniques for couples to reduce pelvic floor tension

Step 8 – Pre-intercourse readiness exercises

Step 9 – Making the transition to intercourse

Step 10 – Full pain-free intercourse & pleasure restoration

For more information on this condition is a very useful site.