Vaginismus might be one of the most puzzling, frustrating sexual conditions that psychologists treat. Since The Buehler Institute specializes in sex therapy, about 10-20% of our clients at any one time are women and partners affected by this condition, which makes penetrative sex of any kind painful or even impossible. Many people who call the Institute for help actually have no idea that there is even a name for this. But vaginismus (va-jah-NIZ-mes) is definitely known by anyone who treats sexual concerns.
Vaginismus is characterized by a spasm in the pelvic floor muscles that causes the entrance of the vagina to contract, sometimes so tightly that there can be no penetration. Many women with vaginismus have found that even tampon use is impossible. Gynecological exam, or PAP smear, can be embarrassing enough, but when a woman's body cannot permit a speculum (an instrument that is inserted into the vagina and spreads its walls, normally a fairly painless procedure) it can become humiliating.
Many couples affected by vaginismus suffer in silence because of this embarrassment. Couples may wait months or even years before they reach out for help. Often, they only contact the Institute because they want to become pregnant. By the time they come into the office, they are often quite desperate.
Vaginismus can be caused by many things, including anxiety or nervousness; lack of education about the body; inadequate preparation for intercourse; problems with lubrication, either due to nervousness or hormone imbalance; and other painful conditions, such as repeated urinary tract infections (UTIs) or even menstrual cramping. There is sometimes an association with past childhood sexual abuse or other sexual assault, but not always, so it isn't wise to simply try digging up the past. Fear of pregnancy and childbirth may also be a factor.
The treatment for vaginismus is very indvidualized. Vaginismus, which is also called hypertonic pelvic floor dysfunction, can be addressed through the use of specialized dilators; appropriate use of lubrication; and sexual education. Cognitive therapy can address a woman's fears about penetration. Behavioral therapy can teach a woman relaxation techniques. Sex therapy can help a couple understand the need for foreplay, and help them learn how to pleasure one another in a relaxed way that is still arousing.
If you or your partner has vaginismus, please contact us for help in the Orange County, CA area. We have helped many women overcome this condition, so we know it is possible to have a normal sex life. Don't be embarrassed–you're not the only one.