How Do I Know if I Have Vaginismus? Signs & Symptoms to Look For

Defined as a penetration disorder, vaginismus is a condition that causes pain, discomfort, or difficulty when inserting something into the vagina. Whether it is a tampon, sex toy, penis, or medical instrument during a pelvic exam, vaginismus triggers an involuntary tightening or spasming of the vaginal muscles that makes penetration painful or impossible. 

Because many women refrain from discussing vaginismus due to embarrassment, statistics are ambiguous when reflecting the percentage of women affected. For example, vaginismus is believed to affect 1-17% of women globally and 12-21% in America. The great news is, vaginismus is treatable and the majority of women fully recuperate. So how do you know if you have vaginismus? Read on to understand more about vaginismus, the possible causes, and some signs to look out for. 

What Causes Vaginismus?

Even though the exact cause of vaginismus remains unknown, research reveals that the involuntary spasming of the vaginal muscles upon penetration is a reaction to a physical source of pain or a psychological trigger that connects penetration with pain. 

Although this protective response is a shared symptom of vaginismus, what causes the underlying fear of penetration differs from woman to woman. Another important factor for women with vaginismus to remember is that it is not their fault - vaginismus is a reflexive condition that stems from an intention to protect the body from pain. 

How Do You Know If You Have Vaginismus: Signs to Look Out For

In addition to pain and discomfort, vaginismus can result in emotional distress that affects a woman’s quality of life, their intimate relationships, and their ability to have children. However, vaginismus can be successfully treated and women can return to, or start enjoying a passionate and enjoyable sex life.

If you notice any of the following signs or symptoms of vaginismus, make an appointment with your doctor, or gynecologist in your area if it's too embarrassing to speak with your usual healthcare provider, and begin treatment for vaginismus as soon as you can to feel relief.    

  • Fear or anxiety about penetration
  • Uncomfortable vaginal muscle spasms during foreplay or oral sex
  • Inability to insert tampons or a sex toy
  • Inability to undergo a pelvic exam or pap smear
  • Painful contractions of the pelvic floor
  • Regular tightness in the pelvic area, hips, lower back & abdominals
  • An unintentional spasming or tightening of the vaginal muscles upon penetration 
  • Stinging or burning pain when something is inserted into the vagina
  • Pain during sex (dyspareunia)
  • The sensation during sex that your partner’s penis has hit a wall inside your vagina
  • Lack of desire for sex due to the anxiety or fear of penetration

Not all women with vaginismus will suffer all the above-mentioned symptoms, and some will report more severe symptoms than others. However, no matter, how mild or severe your vaginismus symptoms are, the condition will improve with treatment. If left untreated, rather than go away on its own, vaginismus will get worse with time. 

For further clarification, vaginismus is also divided into two categories – primary vaginismus & secondary vaginismus. 

The Difference Between Primary & Secondary Vaginismus

Primary vaginismus is the term used when penetration has never been possible, or if possible has always been painful or difficult. It is identified in women who have experienced pain, fear, or difficulty with penetration since their younger years. The first sign of primary vaginismus is often noticed in the teenage years when inserting a tampon for the first time is either difficult, painful, or impossible. 

Primary vaginismus is sometimes due to a lack of, or incorrect, sexual education that leads to a fear of pain during sex or worry about falling pregnant. Primary vaginismus can also be a result of experiencing or witnessing sexual abuse when younger. 

Women suffering from secondary vaginismus, on the other hand, have typically experienced pain-free penetration and enjoyable sex in the past. In these cases, the vaginal tightening upon penetration is typically linked to something that happened later in life. 

After a particularly difficult childbirth or pelvic injury, for example, women can feel anxious about penetration being painful. Vaginal atrophy during menopause, underlying vaginal infections, and interstitial cystitis can also cause pain during sex that could result in vaginismus. 

Is Dyspareunia the Same as Vaginismus? 

Although dyspareunia and vaginismus are often connected and both are considered genito-pelvic pain and penetration disorders, they are different. Dyspareunia is described as pain in the pelvic area during or after sex, whereas vaginismus is defined as pain and anxiety with penetration.

For many women, dyspareunia is often one of the first signs of vaginismus.  

How to Treat Vaginismus

Vaginismus should not be an embarrassing topic to speak about with your doctor, nor should anyone make the choice to live with vaginismus forever. The vaginal tightness and pain caused by penetration is not your fault, but due to some underlying factor that can be treated. 

Treatment options range from using vaginal dilators in the privacy of your own home to physical therapy, sex therapy, relaxation techniques, and surgery, although when dilation is performed regularly, surgery is often avoided.  

Most women suffering from secondary vaginismus are advised to begin vaginismus treatment at home with with dilation therapy. After an initial consultation with a pelvic health physical therapist to explain dilation techniques, patients typically begin with the smallest dilator in a set, similar to the size of a small finger, and progress slowly and gradually toward the larger dilators. This gentle and gradual relaxation of the vaginal muscles allows the vagina to become accustomed to the feeling of penetration and relieves anxiety as well as discomfort and pain. 

For those suffering from primary vaginismus, dilation therapy is typically recommended in conjunction with a therapist to unravel any underlying psychological factors that could be contributing to their vaginismus diagnosis. 

Where to Find the Best Dilators for Vaginismus

Not all dilators are created with the same amount of care, thought, and medical knowledge, but dilators from Intimate Rose certainly are. Designed by pelvic floor physical therapy rehabilitation specialist, Amanda Olson, who has overcome her own share of pelvic trauma, these Silicone Vaginal Dilators from Intimate Rose are the only FDA-registered, medical-grade, vaginal silicone dilators on the market.

Medical-grade silicone is BPA-free, body-safe, and it does not get sticky like other silicone dilators once lubrication for easier insertion is applied. The smoother and softer finish of these medical-grade silicone dilators also means they feel more life-like in the vagina compared with the harder plastic dilators. 

This more human-like sensation, according to vaginismus patients, is far more comfortable inside the vagina and is much better at helping them to relax in contrast to the stiffness of plastic dilators. In our experience, the life-like sensation from Intimate Rose silicone dilators is also more helpful in getting vaginismus patients used to the sensation of penetration from a real penis, rather than hard plastic dilators that feel like medical tools. 

Conclusion

Discomfort, difficulty, or pain during penetration are the primary symptoms associated with vaginismus, however, pain during sex is also a significant indicator. If you experience a burning or stinging sensation when inserting a tampon, sex toy, or penis, or you are unable to undergo a pap smear due to the fear of penetration, schedule an appointment with your doctor or a pelvic health physical therapist for treatment. 

Although uncomfortable, life-altering, and embarrassing for many, vaginismus can be successfully treated with dilators in the comfort of your own home. If left untreated, symptoms will only worsen and surgery may be required. 

References

Cleveland Clinic – Vaginismus - https://my.clevelandclinic.org/health/diseases/15723-vaginismus

Healthline – Dyspareunia - https://www.healthline.com/health/dyspareunia

Science Direct – Vaginismus: An Overview - https://www.sciencedirect.com/science/article/abs/pii/S1743609522011304

National Library of Medicine - Vaginismus Treatment: Clinical Trials Follow Up 241 Patients - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440634/

Emma McGeorge

Physiotherapist and pilates instructor, Emma McGeorge is our founder. Emma spent years managing her own pelvic health issues, and has a wealth of knowledge and experience to share.