Vaginismus causes an unintended and uncomfortable tightening of the vaginal muscles during penetration and often results in painful sex. Although most commonly felt during sexual penetration, the contracting muscles associated with vaginismus can also be felt when inserting a tampon, during a gynecological exam, or Pap smear test.
The good news is that vaginismus is treatable and the majority of women make a full recovery. Read on to learn more about vaginismus, its symptoms, its possible causes, and some effective home remedies for treating vaginismus.
The exact cause of vaginismus remains unknown; however, researchers believe the physical tightening of the pelvic & vaginal muscles is linked to an involuntary psychological fear that vaginal penetration will be painful. In response to this underlying anxiety, the mind signals the vaginal muscles to contract and tighten, essentially restricting penetration to protect the body from expectant pain or discomfort.
Why this happens can vary from woman to woman. For some, the fear of vaginal penetration arises after a pelvic injury, pelvic surgery, or childbirth. While for others it occurs due to the discomfort of vaginal dryness during menopause, because of interstitial cystitis, or an underlying vaginal infection. This type of vaginismus is known as Secondary Vaginismus because the vaginal tightness only occurs later in life after pain-free penetration was once enjoyed.
Primary vaginismus, on the other hand, is diagnosed when women have always felt pain during penetration, even as a teenager when attempting to insert a tampon for the first time. In this case, the anxiety surrounding penetration could arise due to a lack of sexual education, fear of intercourse, anxiety about becoming pregnant, or from having experienced or witnessed sexual abuse earlier in life.
The first sign of vaginismus is a sense of involuntary tightening of the vaginal muscles upon penetration. This happens with intercourse for some women, and while inserting a tampon or undergoing a gynecological exam, for others. For many, the pain disappears after penetration, but for others, it lingers as a constant feeling of vaginal tightness.
This type of discomfort during penetration typically triggers the second symptom of vaginismus, which is a sense of anxiety or fear that anything entering the vagina will cause more pain. And this generally leads to the third symptom of vaginismus – a lack of sexual desire or low libido due to the fear of it causing more pain.
It is common for women to refrain from discussing their vaginismus symptoms due to embarrassment, leaving many completely adverse to sex and countless relationships lacking in intimacy. It is an unfortunate approach given that vaginismus is treatable and 90% of women fully recover to enjoy a satisfying sex life after treatment.
The first step toward treating vaginismus is to consult with your doctor or healthcare practitioner for a correct diagnosis. If the thought of speaking with your usual doctor about your symptoms sparks embarrassment or reluctance, consider making an appointment with another practitioner or gynecologist.
The doctor will typically ask some health and lifestyle questions before performing a gentle pelvic exam to rule out any other underlying conditions or infections. If vaginismus is diagnosed, the doctor will recommend the best treatment option for you.
Treatment options for vaginismus vary slightly depending on whether women suffer from primary or secondary vaginismus, and what caused the underlying anxiety in the first place. The most effective treatment options for vaginismus include pelvic physical therapy, sex therapy, dilator therapy, pelvic exercises, mind-body relaxation techniques, surgery, and some effective remedies that can be practiced at home.
Pelvic physical therapy is often the primary treatment recommended for vaginismus. Specializing in treating dysfunction, discomfort, pain, or weakness in the pelvic and vaginal area, pelvic health physical therapists can help to relax the physical tightness associated with vaginismus through massage and muscle retraining techniques.
To successfully treat and cure vaginismus, physical therapists advise patients to continue the massage and relaxation of the vaginal muscles at home by practicing regular dilator therapy. We’ll discuss more on that below in the home remedies section.
To treat the psychological aspect of vaginismus, a type of mindful therapy is usually done in conjunction with physical therapy.
Women suffering from primary or lifelong vaginismus, for example, often benefit from speaking with a therapist or sex therapist, to unroot the initial cause of their fear and work toward moving past it in time. Vaginismus stemming from a lack of sexual education can be helped by speaking with a sex therapist to better understand the act of intercourse as opposed to believing that it will always be painful.
Those experiencing secondary vaginismus, which is frequently related to recent surgery, pelvic injuries, vaginal infections, menopause, or vaginal dryness, can find relief through a combination of physical therapy, dilator therapy, and relaxation techniques like deep belly breathing or meditation.
The word surgery always sounds grave, but in the case of vaginismus, it is a very short procedure requiring no incisions, sutures, or bandages. Instead, muscle-freezing botox injections are administered directly into the vaginal muscles to prevent them from tightening. The effects generally last for 2-3 months, during which time vaginismus patients are advised to practice daily with a vaginal dilator.
After vaginismus surgery and the post-surgery use of vaginal dilators, most women experience pain-free penetration and return to an enjoyable sex life.
While vaginismus can certainly be treated with home remedies, treatment usually begins, as mentioned above, with the guidance of a physical therapist, and sometimes sex therapists, who specialize in pelvic health. After a few sessions with a PT, they will generally recommend some home remedies to aid the physical recovery of vaginismus. These include:
Designed to gently stretch tight vaginal & pelvic floor muscles, vaginal dilators are highly recommended to relieve pain during sex or penetration. Made from either silicone or plastic, these tubular medical devices come in sets of incrementally ascending sizes to allow women with vaginismus to get comfortable inserting the smallest size before gradually moving up in size to the largest in the set.
In addition to gently stretching tight muscles, vaginal dilators increase blood flow to the vaginal tissues and improve natural lubrication to alleviate atrophy as well as discomfort.
To begin with the correct size dilator for you, female health experts recommend discussing the sizing options with your pelvic health physical therapist, as well as how regularly and for how long you should use your dilator.
Conceived by pelvic floor physical therapist, Amanda Olson, who suffered her own pelvic trauma, these Silicone Vaginal Dilators from Intimate Rose are the only FDA-registered vaginal silicone dilators on the market. Made from medical-grade, body-safe, BPA-free silicone they are considered more comfortable and easier to use than most other dilators and are used in the official Academy of Pelvic Health training courses.
Deep conscious belly breathing, in contrast to breathing into the chest, is an effective relaxation technique that can be practiced at home to treat vaginismus. This type of breathing relaxes the abdominal muscles, which are directly connected to the pelvic floor muscles. Consciously breathing in and out of the belly is also highly effective to engage the parasympathetic nervous system, which reduces the stress hormones released into the body when it is tense.
Instructions for deep belly breathing are as follows:
• Lie down on your back with your hands resting gently on your belly
• Inhale and feel your belly rising against your hands
• As you exhale feel your belly (and hands) falling toward your lower spine
• Repeat at least ten times, 2-3 times per day
Another home remedy for vaginismus is the regular practice of pelvic exercises to retrain the pelvic and vaginal muscles once they have relaxed. The most effective pelvic exercises for treating vaginismus include child’s pose, happy baby, deep squats, pelvic floor drops, and piriformis stretches. You can find detailed instructions for performing each of these exercises here.
Performing them daily can help women to regain control of the pelvic & vaginal muscles and prevent any unintentional tightening of the muscles during future penetration.
Known to affect approximately 7% of women globally, vaginismus not only impacts women’s sexual pleasure but their confidence, relationships, and physical health too. Fortunately, vaginismus is treatable and with the help of physical therapy, dilator therapy, effective home remedies, and relaxation techniques, most women make a full recovery and return to a happy & fulfilling sex life.
Have a read above for more information on the most effective home remedies for treating vaginismus.
Cleveland Clinic - https://my.clevelandclinic.org/health/diseases/15723-vaginismus
Mayo Clinic – Painful Intercourse (Dyspareunia) - https://www.mayoclinic.org/diseases-conditions/painful-intercourse/symptoms-causes/syc-20375967
National Library of Medicine - Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women– Vaginismus https://pubmed.ncbi.nlm.nih.gov/31609735/
Very Well Health – Vaginal Dilators: What You Need to Know - https://www.verywellhealth.com/vaginal-dilators-5220401
Intimate Rose – 6 Vaginismus Exercises & How to do Them -https://www.intimaterose.com/blogs/pelvic-pain/vaginismus-exercises-how-to-do-them
Journal of the Society of American Plastic Surgeons – Botox Treatment for Vaginismus - https://journals.lww.com/plasreconsurg/fulltext/2009/12000/botox_treatment_for_vaginismus.86.aspx