Every time something comes near the vagina – whether it’s a tampon, an attempt at intercourse or even a gynaecological examination – the body reacts with painful muscle spasms. This is vaginismus, a reality for around 12-15% of people with a vagina.
“Can you use a tampon or have intercourse?” According to physiotherapist and pelvic floor specialist Petra Spalding, this should be a routine question during gynaecological examinations. It would allow many sufferers to identify much earlier what’s making life so difficult: Vaginismus, or vaginal muscle spasm, is when the body simply says “no”. This is a medical condition that those affected often feel too ashamed or uninformed to talk about. Which is unfortunate, because what many don’t realise is that help is available.
So what exactly happens in the body with vaginismus? “The pelvic floor and vaginal muscles contract involuntarily, making it impossible to insert anything into the vagina – whether it’s a tampon, a medical instrument or the penis during intercourse.” The pain can feel like something is “tearing” or “cutting” inside the vagina. Some, like Nora, describe it as feeling like “someone is stabbing a knife into my vagina.”
There are two types of vaginismus, primary and secondary:
The causes of vaginismus are complex and not always easy to pinpoint. In some cases, physical factors like infections or injuries can strain the vaginal muscles to the point where the pelvic floor muscles stay tense as a protective reflex. In other cases, psychological causes play a significant role: Traumatic events such as birth trauma, sexual abuse or insecurities and negative experiences around sexuality can all trigger vaginal muscles spasms.
Life stages – whether earlier or later in life – are commonly mentioned in connection with vaginismus: Not only potential insecurities during puberty, but also menopause can bring the condition to light. This is because the vaginal tissue changes as oestrogen levels drop, becoming more sensitive and less elastic, which can lead to pain during intercourse. This pain can then trigger pelvic floor muscle spasms.
Vaginismus isn’t visible from the outside – those with the condition appear healthy, but the pain from vaginal muscle spasms is very real and often difficult to explain. And there's much more to it than the physical pain: Many women feel inadequate or believe there’s something wrong with them. The pressure to function “normally” has an effect on their self-esteem.
For Nora, holidays by the sea were always stressful: “There was this beautiful sea, but I couldn’t go in the water because I had my period and couldn’t insert a tampon. I sat on the beach in long trousers, feeling inadequate. I’d make excuses about heavy period pain, instead of saying what was really going on.” And her sex life? “I’d always push men away before things could get intimate.”
Physiotherapist Petra Spalding is also keen to underline that vaginismus not only has strong physical effects, but a deep emotional impact as well.
What’s good to know: Vaginismus can be treated. A combination of physical and psychological therapy is usually the most effective approach.
In specialised pelvic floor physiotherapy, patients learn to relax their pelvic floor muscles through breathing and stretching exercises. Another important step is the gentle insertion of a finger into the vagina by the therapist, both to check muscle tension and to show the patient that this is possible. As Petra Spalding explains, “I often start with my little finger because it’s very thin. For many women, it’s initially shocking to have someone else do this, but we proceed gently, only going as far as the patient allows.” Nothing is forced: “If the patient isn’t ready or feels pain, we don’t go any further that day. It's a question of trust and patience.”
We proceed gently, only going as far as the patient allows.
The therapy can often include the use of dilators. These are medical devices resembling dildos, which come in different sizes and are gradually inserted into the vagina – either by the patient or the therapist. They enable the muscles to slowly adapt to penetration and help patients regain trust in their own body. The goal is for patients to learn how to relax their muscles and gradually overcome the fear of penetration – all at their own pace.
It's also important to treat the psychological aspect of vaginismus. Depending on a patient’s needs, this may involve sex therapy, trauma therapy or counselling – all aimed at improving the patient’s body image and attitude towards sexuality. Certain cases of pain may require further medical assessment. Sometimes it’s worth having a gynaecologist or vulva specialist take a closer look at the tissue. For this reason, Petra Spalding works within a network of specialists.
Vaginismus is a medical condition that's often not spoken about due to shame. But there’s no need to stay silent: Nora describes how liberating it was to finally articulate her problem and talk about it openly. “It was such a relief when I finally told my girlfriend. After that, I opened up to everyone in my life, and suddenly I didn’t feel alone anymore. Everyone showed understanding; no one looked at me strangely.” Nora has since overcome her vaginismus – but it took intensive therapy. The important thing to know is: Vaginismus can be cured.
If you recognise any of these symptoms in yourself, don’t hesitate to seek help. The first step is to talk to a gynaecologist, who can set you on the path to specialised physiotherapy or other appropriate treatments. Or you can get in touch with one of our Health Coaches.
Secured by Google reCAPTCHA to ensure that you are not a bot. Further Information
