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Vaginismus: causes, symptoms and possible solutions

Vaginismus: causes, symptoms and possible solutions

January 22, 2022

Human sexuality throughout history has been a taboo subject for society, its expression being socially censored and repressed.

The repression of the libido and ignorance regarding the process and the different phases of the sexual response has caused the appearance and non-treatment of various problems that have prevented the full enjoyment of desire and libidinous relations. One of these problems is the disorder known as vaginismus .

Vaginismus: a sexual dysfunction

Vaginismus is a female sexual dysfunction , this type of dysfunction being that group of disorders produced by an alteration of the processes of the human sexual response or the presence of sensations of pain during the act.


This type of disorders can be acquired from a specific life moment or be present throughout life, and its causes can be psychological or a combination of organic and psychic variables. In addition, they can occur both at a general level and in the presence of specific circumstances.

Main symptoms

The main symptom of this disorder is the presence of involuntary contractions persistently and recurrently in time in the vaginal musculature , and especially the pubococcygeus muscle, which contracts and closes the entrance to it.

In this way the entrance to the vagina is not accessible, with what can be prevented or simply difficult (since what is prevented is penetration) the performance of sexual practices. In addition to the maintenance of sexual relations, vaginismus can affect even medical level, greatly complicating gynecological exploration.


The severity of the vaginismus can be very variable, since it can be a slight contraction that may not cause great difficulties until it causes generalized spasms and makes the insertion of any element inside the vagina completely impossible. According to the case, even the thought of introducing some object or being penetrated can cause the muscular contraction characteristic of vaginismus. The attempt to penetrate this state causes deep pain.

The fact of suffering from vaginismus does not imply that the woman who suffers from it does not get excited or enjoy the idea of ​​having relationships, not being infrequent in cases in which the woman in question has a sufficient level of excitement and enjoying the interaction sexual. Thus, penetration is prevented, but other activities of a sexual nature are still viable.

Vaginismus tends to be chronic unless it is treated, and may eventually cause true aversion to sex and the patient shies away from intimacy and the possibility of maintaining relationships.


Possible causes of vaginismus

Vaginismus is a sexual dysfunction that can come from different causes. In some cases it can be derived from a medical condition, such as infections, surgery or in some cases even during menopause.

But nevertheless, it is much more frequent that its origin is due to psychological and psychosocial circumstances , being generally linked to experiences of fear and guilt.

1. Repressive education

The fact of having received a rigid and restrictive education in relation to sexuality It influences in that ideas of guilt, doubt and fear can appear before the realization of the sexual act, thing that can cause the contraction of the vaginal muscles.

2. Traumatic experiences

It is not uncommon for women with vaginismus to have suffered severe traumatic experiences linked to sexuality . People who throughout their childhood have suffered sexual abuse or seen how they were committed, people from families with situations of gender violence or intrafamily violence or women who have suffered rape during their lives are more likely to suffer from dysfunctions sexual as vaginismus due to fear, pain and anxiety linked to the traumatic experience and associated with the performance of the sexual act.

3. Anxiety, guilt and doubts

As is the case with erection disorders in men, The fear, guilt and anxiety before the possibility of not being able to undertake the act can cause that at somatic level the symptoms of vaginismus occur.

Treatments and possible solutions

Vaginismus can be treated with a variety of therapies . Some women come to consult with the idea of ​​having surgery, but this method is not very useful unless its causes are organic, since it does not address the problem itself and its underlying causes, and may even make the situation worse in some cases.

Instead, the following treatments are usually employed, usually in combination.

1. Sex education

Bearing in mind that in many of the cases of vaginismus the people who suffer from it have lived through traumatic experiences or have had a very repressive education with female sexuality, the psycho Education and explanation of the processes considered normal within sexual relationships is a useful tool to take into account and apply. Understanding and explaining your situation and the treatments to be applied can also be a great relief for women with this problem.

2. Techniques of exposure to stimuli

One of the problems that causes and maintains the disorder, as in a great majority of the rest of sexual dysfunctions is the anxiety, fear and insecurity that causes the occurrence of a feared phenomenon , as in this case is the penetration or entry of something inside the vagina. The most effective way to overcome this anxiety is the systematic exposure to the dreaded situation. This exposure must be done gradually, using techniques such as systematic desensitization. The objective is to recognize and overcome fear step by step, until the accomplishment of the act is not aversive or anxious.

As we have said, the process has to be gradual, being able to start with the visual self-observation and continuing with the tactile exploration of the genital area, later on we can proceed with the use of dilators, the hands of the spouse and so on until we reach the performance of the sexual act.

3. Muscular training

One of the most common treatments in vaginismus is performing techniques to control the pelvic muscles, learning to contract and relax them , increasing muscle tone and control of the pelvic area. In this way, the patient can also have a greater sense of control and undertake sexual activity with greater security.

Pubococcygeus muscle training in Kegel exercises is usually the most common procedure.

4. Use of vaginal dilators

Another mechanism that allows to face vaginismus is the use of vaginal dilators . The use of these instruments, applied in a graduated way, allows to diminish the fear and the anxiety before the penetration, at the same time as the pelvic musculature is strengthened.

5. Involving the couple

Vaginismus is a disorder that can be a true source of both psychological and physical suffering to those who suffer from it, limiting intimacy with the partner and ultimately the self-esteem and self-concept of the woman. It is because of that It is necessary that the person with whom relations are maintained , if it is an established couple, be aware of the problem and receive some kind of advice on how to face the situation and help your loved one.

Bibliographic references:

  • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.
  • Hawton, K. & Catalan, J. (1990). Sex therapy for vaginismus: characteristics of couples and treatment outcome. Sexual and Marital Therapy, 5, 39-48
  • Labrador, F.J. (1994). Sexual dysfunctions. Madrid: Fundación Universidad Empresa
  • Masters, W.H. and Johnson, V.E. (1970). Human sexual inadequacy. Boston: Little Brown (Spanish version: Intermedica, Madrid, 1976).
  • Rosen, R.C. and Leiblum, S.R. (nineteen ninety five). Treatment of Sexual Disorders in the 1990s: An Integrated Approach. Journal of Consulting and Clinical Psychology, 63, 877-890.

Should I worry if penetrative sex hurts? (January 2022).


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