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  • Writer's pictureAnna Yam, Ph.D.

I Have Vaginismus, How Can Therapy Help Me?

Updated: Dec 2, 2023

Do your vaginal muscles tighten up whenever you try to have sex or even try to use a tampon? You may have a vaginismus. If this sounds like you, you are not alone. Vaginismus is more common than you might think, and it’s treatable.

What Is Vaginismus?

Vaginismus is an involuntary vaginal muscle spasm that constricts, or narrows the vaginal opening. It prevents many women* from being able to comfortably use a tampon, have a pap smear, have a pelvic exam, and have penetrative sex.

For people with vaginismus, the act of inserting something into the vagina often feels like “hitting a wall.” For those who can insert tampons, fingers or penises into their vaginal opening, it can feel like burning, tearing, or stabbing pain.

About Vaginismus

First of all, you don’t have to continue to endure this pain. This pain is not a normal part of sexual intercourse. If you are having painful penetrative sex, please stop.

Vaginismus is similar to an eye blink reflex. When you see a finger coming towards your eye, you shut your eye reflexively to keep it from being poked.

Your vagina does something similar.

When “it” detects a “threat,” like a tampon, a finger, or a penis, it clenches shut. Of course your vagina doesn’t have its own thoughts (though it might feel that way sometimes). The clenching is a response to what you see as a “threat.”

Vaginismus is a physical, psychological, and social condition. It’s important to pay attention to all of these aspects of vaginismus in order to understand what’s going on for you, and how to treat it.

Physical Part of Vaginismus

Vaginismus involves muscles in your vagina, pelvic floor and sometimes other muscles that connect to the pelvic floor muscles. If you are clenching one muscle group in the body, odds

are you're clenching something else too.

For example, some people with vaginismus unknowingly clench their thighs or their abdomen. Clenching these muscle groups could impact vaginismus recovery.

Psychological Part of Vaginismus

Psychologically, vaginismus is a feedback loop between your brain and the pelvic nerves and muscles. When you detect a threat, the fear response in your brain sends a signal to your vaginal muscles to contract. If penetration is attempted, you experience pain and the nerves send the pain signal back to your brain.

All the nerves and muscles involved “remember” this sequence. The next time a threat comes around, it repeats the sequence even more efficiently - faster and stronger. The threat could feel scarier, the muscles more contracted, the pain more painful.

For some people, even neutral touch in the vulvar area becomes painful, because of this loop being repeated.

As you can see, attempting to “power through” vaginismus and forcing things into your vagina only makes the problem worse.

Social Part of Vaginismus

Socially, vaginismus affects your relationships. People with vaginismus often feel down about themselves. Some report feeling “broken” and "doomed" to be sexless or alone. This can lead to avoiding dating, relationships, and conversations with friends when sex comes up.

Those in a relationship often feel pressure to have intercourse or to "fix" the problem in order to satisfy their partners’ sexual needs. This emotional strain can also impact the level of “threat” associated with penetrative sex. If attempts at sex are emotionally painful, our bodies actually perceive it similarly as they would physical pain.

Many of these negative emotional associations that can perpetuate vaginismus.

Vaginismus Treatment: How to Loosen Up Down There

Comprehensive treatment for vaginismus needs to take into account the physical, psychological, and social aspects of your experience.

  • Physically: Loosening up down there means you must retrain your muscles to relax instead of clenching. This calls for patience and dedication and doesn’t happen overnight. An OB/GYN or Pelvic Physical Therapist can help diagnose and treat vaginismus.

  • Psychologically: It’s important to understand and address topics such as sexual health education, past trauma (including pain), specific or general fears and current stressors. Big unresolved emotions and tightly held traumas nearly always have a biological—body—based impact. It helps to process and release pain and stress in order to open up and bloom in our body.

  • Socially: It helps to address sources of interpersonal stress, threat or pressure. If your partner creates pressure around intercourse, that can interfere with your progress and your recovery.

Want to learn more? Work with me. Check out my online, self-paced Healing Pelvic Pain Course, or get my free Healing Pelvic Pain Guide.

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