Vaginismus occurs when the vaginal muscles tighten and spasm involuntarily, making any penetration very painful. This can happen even though the vagina and vulva are completely healthy, and can impact fertility
Vaginismus is a condition characterised by involuntary contractions of the pelvic floor muscles surrounding the vagina. These spasms can make penetration – whether during intercourse, a gynaecological exam, or even the insertion of a tampon – painful or even impossible. For some patients, the physical nature of this condition is deeply intertwined with psychological factors such as past trauma.
There are two main classifications of vaginismus: primary vaginismus occurs when vaginal penetration has never been achieved, and secondary vaginismus occurs when vaginal penetration has occurred but is no longer possible. Despite the complex and sensitive nature of this condition, it can be managed with the right clinical support.
The causes of vaginismus can be multifaceted, including past trauma, fear of pain, anxiety, or certain medical conditions. For some women, it might arise after years of normal sexual function (secondary vaginismus), while for others, it might have been a lifelong issue. Despite its prevalence, vaginismus remains veiled in silence and stigma, often leading women to suffer alone.
The physical symptoms of vaginismus include:
Psychological symptoms include anxiety and fear associated with occasions that involve vaginal penetration.
Acknowledging your situation and seeking care from a gynaecologist is the first step to recovery. An initial consultation with Dr Parmar may involve a thorough review of your medical and reproductive health history, symptoms, your fertility goals, and a pelvic floor evaluation.
Once diagnosed, a holistic, multidisciplinary treatment approach is often most effective. Dr Parmar maintains close referral relationships with allied health professionals and other clinicians experienced in supporting women living with vaginismus.
By understanding the nature of the condition and exploring various therapeutic options, you can find relief and reclaim your reproductive health. Most importantly, recognising that you are not alone and seeking support can transform the experience of living with vaginismus.
Depending on your condition and your fertility needs, treatment for vaginismus may involve:
A pelvic floor physiotherapist can teach you exercises to relax and strengthen the pelvic floor muscles, gradually reducing involuntary spasms.
Psychological support plays a crucial role. Cognitive behavioural therapy (CBT) and other therapeutic approaches can help address underlying fears, anxieties, or past traumas contributing to the condition.
Using vaginal dilators of increasing sizes, women can learn to gradually acclimate their muscles to insertion, reducing the pain and fear associated with penetration.
In some cases, vaginal procedures, such as a hymenectomy, may be recommended, which may help in reducing the discomfort of penetration. Trying self-insemination or artificial reproductive techniques (ART) under general anaesthetic can be great options for those trying to get pregnant and suffering from vaginismus.
Open, honest discussions about sex, anatomy, and the emotional aspects of vaginismus are essential in providing support to anyone suffering. Education can promote greater awareness, empowerment, and action in helping women who are suffering.
