Vaginismus is a condition where the vaginal muscles tighten involuntarily. This can happen before sex, when inserting a tampon, during a vaginal exam. Vaginismus can be broken into 2 streams: primary or secondary.

Primary is when complete vaginal penetration has never been achieved.
Secondary is when penetration has been achieved in the past with no pain, but this is no longer possible.

Causes of Vaginismus

  • Recurrent UTI’s
  • Endometriosis
  • Trauma associated with childbirth
  • A previous painful pelvic exam
  • History of painful or unpleasant sex
  • Fear of penetration
  • Psychological causes such as history of abuse, strict sexual upbringing, fear

Researchers are unsure of the exact cause for this involuntary muscle tightening but the above have been found to be involved in the condition.

Research suggests that the management for vaginismus be a holistic approach with input from a pelvic floor physiotherapist, gynaecologist and a psychologist or sex therapist.

I won’t be commenting on other discipline approaches but below is what a women’s health therapist would suggest for you following a diagnosis of vaginismus. It is important to work with a women’s health physiotherapist to ensure you are following the correct steps.

  • Education on the anatomy and physiology of the pelvic floor
  • Breathing and relaxation exercises
  • Vaginal dilators
  • Pelvic floor exercises
  • Manual therapy to “tight” muscles
  • Stretching program

As you can see to help manage and resolve vaginismus it takes a team. With these professionals and a treatment plan in place vaginismus can fully resolve. As a women’s health physiotherapist, I would love to be apart of this journey with you to be able to tackle these issues together. Treatment takes time but is well worth it.

Until next time,