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Vaginismus


Definition:

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

Causes, incidence, and risk factors:

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

  • Past sexual trauma or abuse
  • Psychological factors
  • History of discomfort with sexual intercourse

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:

  • Difficult, painful, or impossible, vaginal penetration during sex
  • Vaginal pain during sexual intercourse or a pelvic exam

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.

Signs 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.

Expectations (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.


Review Date: 8/14/2012
Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

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