Vaginismus

Vaginismus is the involuntary contraction (tightening) of the muscles around the opening of the vagina that contributes to discomfort, burning and/or pain, resulting in the inability to insert anything such as a finger, tampon or penis into the vagina.

The symptoms of vaginismus can range from minor discomfort with tightness, to total closure of the vaginal opening with impossible insertion (which may feel like a wall or barrier). Vaginismus can occur during any stage of life and is a common cause of ongoing sexual dysfunction.

Vaginismus is a diagnosis of exclusion, which means you need to be seen by your doctor to rule out other medical conditions.

There are Two Main Forms of Vaginismus:

Primary Vaginismus: A lifelong condition where symptoms have always been present from the first attempt at vaginal insertion such as a tampon, finger, or penis.

Secondary Vaginismus: A condition that starts later in life, where symptoms started after a period of time when you were able to successfully and asymptomatically insert a tampon, finger, or penis.

Physical Contributors to Vaginismus:

• No Cause
• Pelvic trauma such as surgery, radiation or sexual abuse.
• The aftermath of childbirth.
• Age-related factors including menopause and hormonal changes that contribute to dryness and inadequate lubrication.

Non-Physical Contributors to Vaginismus

• No Cause
• Traumatic events.
• Negative associations with relationships and sex.
• Fear of pain.
• Anxiety and stress.
• Early childhood adverse experiences.

Physiotherapy has been shown to be an effective part of a multidisciplinary approach to improve these symptoms. Physiotherapy treatment is safe, gentle and may initially not start with an internal component.

Physiotherapy Treatment Often Includes:

• Improving pelvic floor proprioception (awareness).
• Deep breathing and relaxation.
• Pain education.
• Progressive desensitization.
• Body mapping.
• Addressing connective tissue dysfunction.
• Addressing fear around insertion.
• Education and instruction on the use of accommodators and dilators.
• Gentle, pain-free internal work to help decrease pelvic floor over-activity and tension.

A multidisciplinary approach of pelvic physiotherapy and cognitive sexual therapy has proven successful for many patients. There are wonderful sex therapists who can help in this area. Their website is www.bestco.info (Board of Examiners in Sex Therapy Counselling in Ontario).