Vaginismus

Vaginismus is a distressing condition in which the muscles around the vagina tighten involuntarily whenever there is an attempt at penetration. This includes penetration with a tampon as well as sexual contact. As a result sexual intercourse becomes difficult, impossible or painful making it very hard for suffers to enjoy a normal sex life or to start a family.

Symptoms

What causes vaginismus?

Vaginismus usually results from a past sexual trauma - perhaps a painful sexual encounter or examination at a young age or sexual assault or rape. It can also occur in people who feel guilt around sex perhaps due to a strict upbringing. Tiredness, depression or the fear of getting pregnant can also cause vaginismus.

How is the condition treated?

Treatment usually involves a combination of counselling and muscle exercises. Your GP will most likely refer you to a sex therapist, counsellor and/or gynaecologist.

Pelvic floor exercises may be recommended - these involve repetitive contraction and relaxation of the pelvic floor muscles so that the patient gains improved control over her vaginal muscles.

Vaginal dilation exercises may also be advised. These involve using penis-shaped cones that gradually increase in size to be used in the privacy of the home. The woman gradually increases the size of the dilators and may be asked to exercise her pelvic floor muscles while a cone is inserted.

If in a relationship, a sex therapist may recommend sensate focus - which is a type of sex therapy in which the couple build-up to sex through touching exercises. Sex therapy is available through the NHS or privately.

Psychological counselling is another central part of treatment, particularly if the condition is due to a past sexual trauma. Treatment might include cognitive behavioural therapy (CBT) which changes negative or irrational patterns of thinking.

Occasionally surgery may be offered as a treatment for vaginismus. This will be suggested only if there is a physical basis to the problem - for example due to endometriosis - a condition where small pieces of the womb lining grow outside the womb. Surgery can also be used to enlarge the vagina if previous surgery to this area has caused scar tissue to block or restrict the vagina.