For some women, the vaginal muscles involuntarily or persistently contract when they attempt vaginal penetration. This is called vaginismus. The contractions can prevent sexual intercourse or make it very painful.
Diagnosis of vaginismus usually begins with describing your symptoms. Your doctor will likely ask:
- when you first noticed a problem
- how often it occurs
- what seems to trigger it
Typically, your doctor will also ask about your sexual history, which may include questions about whether you’ve ever experienced sexual trauma or abuse.
In general, diagnosis and treatment of vaginismus require a pelvic exam.
It’s common for women with vaginismus to be nervous or fearful about pelvic exams. If your doctor recommends a pelvic exam, you can discuss ways to make the exam as comfortable as possible for you.
Some women prefer not to use stirrups and to try different physical positions for the exam. You may feel more at ease if you can use a mirror to see what your doctor is doing.
When a doctor suspects vaginismus, they’ll generally perform the exam as gently as they can.
They may suggest that you help guide their hand or medical instruments into your vagina to make penetration easier. You can ask your doctor to explain every step of the exam to you as they go along.
During the exam, your doctor will look for any sign of infection or scarring.
In vaginismus, there’s no physical reason for the vaginal muscles to contract. That means, if you have vaginismus, your doctor won’t find another cause for your symptoms.
Treatment Options for Vaginismus
Vaginismus is a treatable disorder. Treatment usually includes education, counseling, and exercises..
Sex Therapy and Counseling
Education typically involves learning about your anatomy and what happens during sexual arousal and intercourse. You’ll get information about the muscles involved in vaginismus, too.
This can help you understand how the parts of the body work and how your body is responding.
Counseling may involve you alone or with your partner. Working with a counselor who specializes in sexual disorders may be helpful.
Relaxation techniques and hypnosis may also promote relaxation and help you feel more comfortable with intercourse.
Vaginal Dilators
Your doctor or counselor may recommend learning to use vaginal dilators under the supervision of a professional.
Place the cone-shaped dilators in your vagina. The dilators will get progressively bigger. This helps the vaginal muscles stretch and become flexible.
To increase intimacy, have your partner help you insert the dilators. After completing the course of treatment with a set of dilators, you and your partner can try to have intercourse again.
Physical Therapy
If you have a hard time using dilators on your own, obtain a referral to a physical therapist who specializes in the pelvic floor.
They can help you:
- learn more on how to use dilators
- learn about deep relaxation techniques
Surgery
Sometimes vaginismus is mistaken for a physical problem with your vagina, which can lead to needless surgery. Very few cases of vaginismus require surgery.
