Vaginismus

Involuntary muscle spasm in the pelvic floor making it painful, difficult or impossible to have sexual intercourse, insert a tampon or undergo a gynecological exam. Can be caused by physical stressors, emotional stressors, or both. 

  • Primary Vaginismus- condition has always been present, and person has never been able to insert tampon or receive gynecological exam. 

  • Secondary Vaginismus- occurs later in life, after person has previously been able to have vaginal penetration. Often stems from a singular event, such as trauma, infection, relationship issues, or childbirth.

  • Global Vaginismus- always occurs, no matter the situation. 

  • Situational Vaginimis- occurs only in certain situations (eg. may only happen during sex, and not with a tampon or gynecological exam). 

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Treatments:

  • Pelvic floor physical therapy- utilizing breathing and other physical strategies to connect to your pelvic floor and learn ways to relax, and activate the muscles.

  • Education and counseling- providing education about anatomy and the science of pain to better understand your body's responses. A counselor who specializes in this diagnosis can help with the emotional aspect of vaginismus. 

  • Reducing sensitivity to insertion- touching the areas around the vaginal opening, working up to touching the external anatomy such as the labia and eventually working towards inserting a finger or tampon. A pelvic floor PT can assist in this process. 

  • Dilator training- Once it's possible for an object to enter the vaginal opening, a small dilator can be inserted and left to stretch the tissue and allow for you to become comfortable with the sensation. Then progress dilator size as you are able. A pelvic floor PT can assist in this process.

  • Time and patience- This process can take time, and it doesn't help to get frustrated and force yourself to move quicker than you are ready for.  Stress can worsen the symptoms, so the less pressure you put on yourself, the better.