Vaginismus – When using a tampon is impossible and sex seems unimaginable!

Vaginismus is estimated to affect 1 in 10 Australian women, yet is often under diagnosed and left untreated. Vaginismus can be described as recurrent or persistent involuntary spasm of the pelvic floor that interferes with sexual intercourse or other types of penetration. It may limit your ability to insert things into your vagina like tampons, fingers, vibrators/dildos, or a penis. It may also cause painful gynaecological examinations. For some people they may have always struggled to insert something into the vagina (primary vaginismus) and for others they might have previously had no issues with penetration and developed vaginismus later on due to trauma, surgery, or with an insidious onset (secondary vaginismus). 

It can often feel like your vagina is literally “shut”; Like there is no opening and that the idea of putting something inside the vagina simply seems impossible. The reason for this feeling is because the muscle that surrounds the entrance of the vagina (bulbospongiosus) goes into involuntary spasm causing a restriction to the opening of the vagina. This then means that if something is trying to enter the vagina, the vaginal opening is unable to relax and allow for penetration to occur.

Trying to push past this muscle spasm can be incredibly painful and in some cases may feel impossible. This muscular response can be due to a fear or threat response (e.g. in response to a previous trauma) or due to psychological reasons (such as shame around sexuality or masturbation) or in the case of someone who is concerned about the appearance of their genitals or how they present sexually. 

The reason for the pelvic floor muscle spasm is often a combination of psychological and physical reasons and so your treatment team often includes both a physiologist, physiotherapist and gynaecologist.  

Symptoms of vaginismus may include: 

• Pain or inability to use tampons or other menstrual products
• Painful intercourse often with tightness, burning or stinging 
• Pain or inability to use a vibrator/dildo internally 
• Penetration being difficult or impossible 
• Pain during gynaecological exams. 

Treatment 

As touched on above, treatment for vaginismus often involves a team of care providers and is often multifactorial. 

Exploring your beliefs and experiences: Seeing a sexologist or psychologist can be pivotal in treating vaginismus. These professionals can help explore your beliefs around sex, shame, and body image or can help you work through trauma or fear responses to past experiences. 

Pelvic Floor Physiotherapist: As well as dilator therapy, seeing a pelvic floor physiotherapist will allow your treatment to be tailored to you. A pelvic floor physio will use several different techniques and tools to assist you to achieve pain free penetration. This might include things like bio-feedback, dilator therapy, manual muscle release work (like a massage for your pelvic floor), stretches and exercises, breath work, and so so much more! 

Dilator therapy: Dilators can be a fabulous tool to help gradually stretch the vaginal walls and pelvic floor muscles to allow for pain free penetration. Not only do they provide a physical stretch to the muscles, but they also allow the brain to gradually experience penetration at different sizes in a pain free, controlled way. Starting with the our smallest dilator set would be the best place to start if you have vaginismus. 

Getting an accurate diagnosis: Seeing a pelvic floor physiotherapist or gynaecologist (or both!) that specialises in pelvic pain is so important, especially to validate your pain and experiences. 

Vaginismus is a treatable and curable condition – you do not have to suffer in silence.