If you experience vaginal pain while inserting a tampon or menstrual cup, during sex, having a gynecological exam, or in other circumstances, you might have vaginismus. Pain, discomfort, or numbness in these situations is unfortunate and can lead to avoiding romantic relationships, loneliness, or the perpetuation of more pain. The good news is that you are not alone, and vaginismus can be treated.

Vaginismus Defined

According to the Cleveland Clinic, vaginismus is the “involuntary tensing or contracting of the muscles around the vagina...The unintentional muscle spasms occur when something— a penis, finger, tampon, or medical instrument— attempts to penetrate the vagina. The spasms may be mildly uncomfortable or very painful.”

Symptoms of vaginismus can go beyond pain, which can range from dull and numb to sharp sensations of burning, cramping, and stinging. In some instances, penetration or insertion of a tampon or menstrual cup can be made incredibly difficult or impossible because of muscle spasms and tightening. And while not a direct symptom of vaginismus, these sensations and experiences can lead to anxiety or emotional disturbances and avoidance of sex and intimacy.

Vaginismus can occur from the onset of sexual activity, but it can be spurred by life events, physical or emotional trauma, surgery, childbirth, infection, menopause, and more. Medical News Today describes four types of vaginismus: 

• Primary vaginismus is a common experience for women during their first time having sex. They may feel tightness or tension upon penetration.
• Secondary vaginismus can be triggered at any point by a physical or emotional life event or trauma.
• Global vaginismus is ever present and easily triggered.
• Situational vaginismus is triggered by specific events, for example, when at the gynecologist but not while inserting a tampon or menstrual cup.

Causes of Vaginismus

Vaginismus can be caused by physical or emotional trauma, and is likely a combination of both. Likely causes and triggers include:

• Sexual assault
• Abuse or history of abuse
• Childbirth
• Shame or guilt about sex 
• Performance anxiety
• Fear of pain
• Fear of pregnancy
• Fear of vulnerability
• Lack of libido
• Inadequate foreplay 
• Insufficient lubrication
• UTI or yeast infection
• Menopause
• Pelvic surgery
• Infection
• Cancer or other medical conditions in or around the vagina and pelvic area
• Medication side effects

What to do if You Think You Have Vaginismus

If you think you might have vaginismus, seek advice from a medical professional. Here are a few pieces of information you can bring to your appointment:

• When does the pain begin? Is it triggered by specific events? Or is it all of the time?
• Describe the pain. Is it dull and numb? Sharp? Burning and stinging? 
• Is the pain in a specific area? 
• Imagine your vagina has four quadrants: right front, left front, right back, left back. Which quadrant(s) does the pain reside in?
• Now imagine your vagina has three vertically stacked sections: bottom (your vaginal opening), middle, and top (near your cervix). Which vertical stacked section does the pain reside in?
• How is your pain impacting you? Your sex life? Menstrual cycle? Daily activities? 

Once your medical provider has ruled out any other underlying causes and determined if you have vaginismus, they will recommend a treatment plan. 

Treatment for Vaginismus

Treatment for vaginismus can include a variety of activities to reduce muscle spasms and tightening:

• Physical therapy:  Core exercises, lower body exercises, stretching, internal massage, external massage
• Desensitizing penetration or insertion: Personal touch exercises, working with dilators or wands
• Counseling or emotional support: Talk therapy, reflective exercises
• Breathwork and meditation
• Botox

Your medical provider (gynecologist, physical therapist, counselor) will work with you on creating a treatment plan that fits your goals and needs.

You are Not Alone

If you have vaginismus or any kind of vaginal or vulvar pain, know that you are not alone. Many people are deterred from seeking help for vaginismus because of feelings of shame or guilt. And many women can be misdiagnosed. This makes it difficult to understand the breadth of the problem and how many women are suffering from vaginismus.

The American College of Obstetricians and Gynecologists estimates that 75% of women have painful sex at some point in their lives. One Australian study found that about 20% of women suffer from painful sex. Another study found that 57% of women who visited a sexual health clinic system reported having painful sex, and 60% of them were diagnosed with vaginismus.

There is Hope For Recovery if You Have Vaginismus

If you are struggling with vaginismus, know that you are not alone, and you already have the tools needed to overcome it. In fact, many of the treatment options that medical providers will offer are addressed holistically through the practice of yoga. If you're curious to learn more about how yoga can supplement your vaginismus journey and the work you do with a physical therapist or psychologist, download the FREE Mind + Body + Spirit Guide to Lasting Change.