Vaginismus is painful, reflex muscle spasm of the vagina and leg muscles, which occurs when sexual intercourse is tried or anticipated.
When a woman has vaginismus, muscle spasms cause the vagina and leg muscles to tighten reflexively. Putting a finger or penis in the vagina is quite painful. Often it cannot be done.
The problem is often linked to past sexual trauma. Other factors, such as fear of pregnancy or venereal disease, may also be present.
Some contributing factors are:
The key symptom of vaginismus is vaginal tightness strong enough to make intercourse impossible. The pain may cause a woman to avoid sexual intimacy.
A healthcare provider will take a medical history and ask about episodes of vaginismus. A pelvic exam will be done, too. During it, the provider will try to gently insert a finger or fingers into the vagina to see if this causes a painful spasm of vaginal muscles and tightened leg muscles.
Because sexual activity is painful for a woman with vaginismus, relationships are often avoided, or marred by discord and dissatisfaction. Lingering questions about sexual preference may never be resolved.
A woman's partner may start to view himself as a sexual failure. Problems having an erection or impotence may result.
Treatment usually involves counseling to get at the root psychological cause for the vaginismus. Some experts use a program that slowly makes it easier to relax vaginal muscles so that the vagina opens up. A reputable sex therapist or gynecologist familiar with the problem may suggest:
Until a woman is able to relax her muscles, using dilators in the vagina may be uncomfortable and irritating. Therapy may uncover difficult issues that could trigger deep depression or anxiety.
Author:Eva Martin, MD
Reviewer:Sandy Keefe, RN, MSN