Vaginismus

Definition

Vaginismus is an involuntary spasm of the muscles surrounding the vagina. The spasms close the vagina.

Causes

Vaginismus is a sexual problem. It has several possible causes, including:

Sometimes no cause can be found.

Vaginismus is an uncommon condition. The exact number of women who have this problem is unknown.

Symptoms

The main symptoms are:

Women with vaginismus often become anxious about sexual intercourse. However, this does not mean they cannot become sexually aroused. Many women with this condition can have orgasms when the clitoris is stimulated.

Exams and Tests

A pelvic exam can confirm the diagnosis of vaginismus. A medical history and complete physical exam are important to look for other causes of pain with sexual intercourse (dyspareunia).

Treatment

Treatment involves a combination of education, counseling, and exercises such as pelvic floor muscle contraction and relaxation (Kegel exercises).

Vaginal dilation exercises are recommended using plastic dilators. These should be done under the direction of a sex therapist or other health care provider. Therapy should involve the partner. It can gradually include more intimate contact, ultimately leading to intercourse.

Your health care provider should give you information about sexual anatomy, the sexual response cycle, and common myths about sex.

Outlook (Prognosis)

When women are treated by a specialist in sex therapy, success rates are generally very high.

References

Cowley D, Lentz GM. Emotional aspects of gynecology: depression, anxiety, PTSD, eating disorders, substance abuse, "difficult" patients, sexual function, rape, intimate partner violence, and grief. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 9.