Vaginismus, sometimes called vaginism, is the physical or psychological condition that affects a woman’s ability to engage in any form of vaginal penetration, including sexual intercourse, insertion of tampons or menstrual cups, and the penetration involved in gynecological examinations (pap tests). This is presumed to be the result of an involuntary vaginal muscle spasm, which makes any kind of vaginal penetration painful or impossible. While there is a lack of evidence to definitively identify which muscle is responsible for the spasm, the pubococcygeus muscle, sometimes referred to as the “PC muscle”, is most often suggested. Other muscles such as the levator ani, bulbocavernosus, circumvaginal, and perivaginal muscles have also been suggested.
A woman with vaginismus does not consciously control the spasm. The vaginismic reflex can be compared to the response of the eye shutting when an object comes towards it. The severity of vaginismus, as well as the pain during penetration (including sexual penetration), varies from woman to woman.
- Burning or stinging with tightness during sex.
- Difficult or impossible penetration, entry pain, uncomfortable insertion of penis.
- Unconsummated marriage.
- Ongoing sexual discomfort or pain following childbirth, yeast/urinary infections, STDs, IC, hysterectomy, cancer and surgeries, rape, menopause, or other issues.
- Ongoing sexual pain of unknown origin, with no apparent cause.
- Difficulty inserting tampons or undergoing a pelvic/gynecological exam.
- Spasms in other body muscle groups (legs, lower back, etc.) and/or halted breathing during attempts at intercourse.
- Avoidance of sex due to pain and/or failure.
Usually at the root of vaginismus is a combination of physical or non-physical triggers that cause the body to anticipate pain. Reacting to the anticipation of pain, the body automatically tightens the vaginal muscles, bracing to protect itself from harm. Sex becomes uncomfortable or painful, and entry may be more difficult or impossible depending upon the severity of this tightened state. With attempts at sex, any resulting discomfort further reinforces the reflex response so that it intensifies more. The body experiences increased pain and reacts by bracing more on an ongoing basis, further entrenching this response and creating a cycle of pain.
For many women, vaginismus comes as a surprise; unexplained tightness, discomfort, pain, and entry problems are unexpectedly experienced during intercourse attempts. The pain results from the tightening of the muscles around the vagina (PC muscles). Since this occurs without the conscious intent or control of the woman, it can be very perplexing.