Vaginismus is a pelvic health condition that has been reported to occur in 5-17% of the female population; however, it remains underdiagnosed and undertreated worldwide. Vaginismus refers to when any form of vaginal penetration such as tampons, digits, dilators, gynecologic examinations, and intercourse is often painful or impossible [1]. Understandably so, this condition can have a profound impact on an individual’s physical and emotional well-being.
In this blog, we will delve into what vaginismus is, explore its causes, symptoms and most
importantly, how pelvic floor physiotherapy can help successfully treat this condition!
What is Vaginismus?
Vaginismus is a pelvic health condition characterized by the involuntary contraction or spasm of muscles around the vaginal opening. This reflexive muscle tightening can occur during sexual intercourse, gynecological exams or attempts at inserting a tampon. Engaging in these activities is often very painful or even impossible. For many, this automatic contraction or spasm of the vaginal muscles is a protective mechanism, set in motion by the nervous system, to protect against actual or anticipated pain with insertion.
What causes Vaginismus?
The exact cause of vaginismus is unknown; however, different psychological factors such as fear, anxiety, traumatic sexual experiences, sexual abuse, negative attitudes towards sex and sexuality as well as relationship issues/stress have been associated with this condition [1]. Other potential contributing factors include history of vaginal infections, trauma or previous injury/surgery in the pelvic region, vaginal atrophy, or dryness.
Symptoms of Vaginismus
Some common symptoms of vaginismus include:
• Inability to penetrate: difficulty, inability, or severe pain with vaginal penetration, which
can include sexual intercourse, insertion of tampons or medical devices
• Pain and discomfort: sensations of burning or tearing with attempted penetration
• Anxiety and Distress: emotional distress, anxiety and fear associated with sexual activity
or gynecological exams
Pelvic Health Physiotherapy can help!
Many individuals who seek treatment from a Pelvic Health Physiotherapist for vaginismus find success in addressing this condition. Whether clients have the goal of inserting a tampon without pain, having sex without pain or completing a gynecological exam without pain, Pelvic Health Physiotherapists can help in the following ways:
1. Assessment: a thorough medical and psycho-sexual history will be taken. This will
include questions regarding vaginal penetration, fear and anxiety related to penetration
and pain. If the client is willing and comfortable, a pelvic floor physiotherapist may also
include external and/or internal evaluations of muscle tone and flexibility in the vaginal
region. The Pelvic Health Physiotherapist will discuss goals with the client and will tailor
treatment to meet those goals.
2. Education: Clients will receive education on vaginismus as it relates specifically to them.
This will include learning about pelvic floor anatomy, its function and why they may be
experiencing their symptoms. At this point, a pelvic floor physiotherapist will walk the
patient through options for treatment and future sessions.
3. Muscle Relaxation Techniques: With the protection of the nervous system playing a big
role in many vaginismus clients, a Pelvic Health Physiotherapist will help patients retrain
and calm the protective signals from their nervous system. This will help patients gain
control over their pelvic muscles through learning techniques such as breathing exercises,
muscle relaxation and biofeedback.
4. Manual Therapy: Hands on techniques such as soft tissue release can help to address any areas in the pelvic region where there may be increased sensitivity or muscle tension.
5. Dilators: Dilator therapy may be introduced into a client’s regime, which can help
gradually increase tolerance to vaginal penetration.
While vaginismus can significantly impact a person’s quality of life, it is incredibly important to remember that it is treatable it is not something that someone has to live with forever.
At Mississauga Pelvic Health, we are here to support you on your journey to feeling like your
best self again!
If you have any questions or would like to start your pelvic health journey,
1. Pacik, P. T., & Geletta, S. (2017). Vaginismus Treatment: Clinical Trials Follow Up 241 Patients. Sexual medicine, 5(2), e114–e123. https://doi.org/10.1016/j.esxm.2017.02.002