Vaginismus questions and answers

Vaginismus (also known as vaginism) is a sexual problem affecting women. It causes penetration to be painful or impossible due to the tensing of the vaginal muscles. Sufferers may also experience anxiety and difficulty inserting tampons or undergoing gynaecological examinations.

It is an emotional and psychological condition. The causes of it are psychological, although it manifests as a physical condition. This vaginal tightness may cause sexual discomfort or pain, burning or tearing sensations, and inability to have sex or insert any object into your vagina.

Vaginismus is the main cause of unconsummated relationships, and it can put relationships under great strain. It is extremely frustrating to be unable to physically engage in pleasurable sex and sufferers often feel abnormal and embarrassed about the condition. The anticipation of pain or sexual ‘failure’ further contributes to and reinforces the symptoms of vaginismus. This can lead to avoidance of penetration and a feeling of alienation from ones own body as the vagina becomes a no-go zone. This exacerbates negative emotions such as feelings of failure, or general squeamishness about ones vagina.

Vaginismus varies in levels of severity and manifests itself in different ways for each woman. The main types of vaginismus are as follows: PRIMARY VAGINISMUS where the woman has never experienced full pain-free penetration. SECONDARY VAGINISMUS is where the woman was previously able to have pain-free penetration. It can occur after her having had some sort of medical condition that caused sexual pain such as long-term cystitis and, although the original condition is no longer present, her fears about penetration continue. Some women develop vaginismus after menopause; when oestrogen levels drop, a lack of vaginal lubrication and elasticity makes intercourse painful. It can also be triggered by her reaction to a negative sexual experience or difficulties in her relationship with her partner. SITUATIONAL VAGINISMUS - This occurs only in certain situations or with certain partners. The occurrence of it may seem entirely random and unpredictable.

It’s impossible to know how many women suffer from this condition as there exists no centralised body that collates information on vaginismus. Many women suffer in silence and feel too embarrassed to tell their doctor. The water is further muddied by incorrect diagnoses from doctors and other specialists.

I personally receive many enquiries every day from women with the condition. Hopefully you will find this reassuring as it can be easy to believe you’re the only one suffering from this problem!

Ideally, you should visit your GP go to a sexual health clinic if you think you might have vaginismus. You may feel embarrassed about seeking help, but it is important to be able to rule out other possible physical causes of any symptoms. If your doctor suspects vaginismus, they may be able to refer you to a specialist, such as a gynaecologist. There are many specialists out there and a knowledgeable and astute specialist will be able to correctly diagnose the problem.

It is likely that you have vaginismus if you experience some or all of the following:

• You feel very anxious or fearful at the thought of penetration.
• You feel alienated from your vagina.
• You feel a sense of squeamishness or disgust towards your vagina.
• You avoid penetration due to fear of pain or other negative emotions. This may include avoidance of tampons, sex or gynaecological examinations.
• You feel as though there is a ‘wall’ or other obstacle inside your vagina preventing penetration or you imagine your vagina to be abnormally narrow.
• You experience a burning or stinging pain and tightness of the vagina if penetration occurs. This can range from mild discomfort to extreme, unbearable pain.

I can only answer this question based upon the clients I have seen, but they are generally not women who have experienced past sexual trauma (despite what you may have read elsewhere). The vast majority of my clients are women with unremarkable sexual pasts. Most of my clients are bright, educated and professional women. Most are religious, although having a religious background isn't a direct cause of vaginismus. What these women do also have in common, however, tend to be the following:

• Overthinkers / worriers
• Disconnected and alienated from their vaginas
• Perfectionists who can often put themselves under pressure (particularly about work/education/'performance' situations)
• Women who dislike or avoid out-of-control type situations (and penetration can be considered such a situation)
• Fear of getting things wrong, fear failure, and judgement from others

It is your current mindset and beliefs and that cause the physical responses behind vaginismus. Which is great, because you can change all of these! See the Vaginismus-Free Programme here.

It can be easy to attribute vaginismus to a physical abnormality if you don't have the necessary insight and understanding as to how you are creating the muscle tension with some unhelpful thoughts and beliefs.

Most vaginismus sufferers look ‘externally’ for why they have the symptom: believing it must be due to past experiences or that there must be something wrong with your body.

It is these beliefs that make you feel powerless and helpless in overcoming the problem (because you can't necessarily change these things). The key to resolving vaginismus is to look more ‘internally’, ie, how could my beliefs and thinking TODAY be causing the physical tightness - for that is where the true answer lays.

Data from 25 of Cara's clients (in November 2024) reveals that when they first began the programme, 52% believed their was something physically wrong with their body. At the end of the programme, NOT ONE woman believed that.

Most of my vaginismus clients had tried other interventions before coming to see me, sometimes investing a great deal of time and effort. These range from psychosexual therapy, physiotherapy, Kegel exercises, Botox injections, all the way through to trying voodoo (quite literally!). However, these interventions often do not fully address the REAL causes and components of the condition. It’s then understandable that when they fail, the woman is left feeling even more hopeless and the belief that vaginismus is very hard to overcome is reinforced.

Vaginismus is NOT difficult to overcome - as long as you focus your efforts in the correct direction. A good analogy for this is if you were to lose your car keys in the garden, you could search endlessly in the house but will never find them. It's not that they are difficult to find, but you have to search in the right place.

It can be easy to believe that it can take a long time to overcome vaginsimus - especially if you have already had it for a long time and the interventions you have tried have been unsuccessful. With the correct insight and methods of treatment, it is entirely possible to fully overcome vaginismus in 8-12 weeks.

Absolutely not! In order to have vaginismus, there are some very specific psychological process going on behind the scenes which cause the tensing of the vaginal muscles. No one ever taught you how to manage your thinking well. No one ever taught you how to create strong beliefs. No one taught you how to control your thinking, or about the mind-body connection. Without these invaluable insights it's no wonder that problems can arise in life. So no, you're NOT a failure and it's not your fault that you are struggling right now!