Vaginismus (Vaginal Spasm)

By | June 10, 2022

Vaginismus, or vaginal spasm, is the sudden, uncontrollable, and painful spasm of muscles in the pelvic floor and vagina. In order to break a negative cycle between pain and the fear of another spasm, it is necessary to look for the causes at an early stage. These are either physical, but in most cases they are psychological. The therapy depends on the respective causes, whereby in the case of psychological triggers an individual combination of psychotherapy, relaxation exercises, pelvic floor training and the use of vaginal dilators to treat the vaginismus is often used.

What is vaginismus?

Vaginismus (vaginal spasm) is the involuntary and extremely painful spasm of the muscles of the pelvic floor and parts of the vagina. For hemorrhoids meaning, please visit

The result of the suddenly occurring, extreme tension is a significant narrowing of the vagina with the consequence that gynecological examinations, sexual intercourse or the insertion of objects ( tampon, fingers) are associated with severe pain or are even impossible – even if the insertion is done by the woman it is asked for. As a rule, she herself cannot influence the muscle spasm that occurs reflexively.

Since recurring vaginal cramps also represent a psychological burden for the woman concerned as well as a massive restriction in her sexuality and thus her quality of life due to the growing fear of anticipation, a prompt investigation into the causes or treatment of the vaginismus should be initiated by a trusting doctor.


Vaginismus is one of the painful sexual dysfunctions and can have both physical and psychological causes.

In the physical area, for example, a difficult-to-penetrate hymen, a narrowed vagina due to a septum, infections, hormonal causes or functional disorders of the pelvic floor muscles are among the classic triggers. The psychological causes include a traumatic sexual experience, a negative birth experience or an upbringing that devalued sexuality.

In medicine, a distinction is also made between primary vaginismus – in this case the woman was never able to insert anything into the vagina – and secondary vaginismus, a defensive reaction triggered by a negative event.

The sudden occurrence of the spasm and the pronounced pain symptoms cause most women to have an intense fear of anticipation of the next seizure, so that the psychological component of vaginismus must always be taken into account, even if the cause is physical.

Symptoms, Ailments & Signs

Vaginismus describes the involuntary, spasmodic narrowing of a woman’s vagina. The extent of the cramps can vary greatly. Some women cramp during an exam at the gynecologist, but cramps rarely occur in other women. The cramping is usually in the outer third of the vagina when the penis penetrates. However, some sufferers also experience vaginal spasms and some sufferers may experience spasms in the pelvic floor muscles.

The spasm is accompanied by a stabbing, throbbing pain and a strong burning sensation. Since vaginismus occurs most frequently during sex, affected women suffer greatly and avoid sexual contact. Since vaginismus can also be caused by the insertion of a tampon in some cases, secondary symptoms such as poor hygiene or inflammation can occur.

Vaginismus is not only accompanied by a panic fear of the pain that occurs, but is also often a taboo subject. Many women are afraid to talk to their doctors about it. In some cases, gynecologists are avoided directly because the examination can produce cramps. In some cases, vaginismus may indicate a psychological cause, such as abuse. Such psychological causes can be inquired about in cautious conversations with the doctor.

Diagnosis & History

An important building block for the diagnosis of vaginismus is the description of the symptoms of the vaginal spasm by the patient. Whether a gynecological examination of those affected – for example to rule out birth injuries, strictures or infections – is even possible depends on the individual extent of the disorder in question.

Psychological causes such as a traumatic experience (rape, abuse, painful gynecological examination) are discussed in careful discussions with the doctor or psychologist. However, a prerequisite for diagnostics and treatment is that the woman turns to her doctor and, if necessary, to her partner about the supposedly taboo subject of vaginismus.

This is the only way to break the vicious circle of fear of expectation and painful cramps and to avoid permanent sexual disorders and possible negative effects of vaginismus on the partnership.


Vaginismus almost always affects sexual relationships, since penetration is either impossible or painful. In some cases, there is also a fear or aversion to sexual situations.

Women who are in a relationship may put themselves under psychological pressure to “function”. However, this can even increase vaginismus. Relationship conflicts are also possible if the other partner’s sexual needs remain unsatisfied or if the partner does not have sufficient understanding of the complaints.

As a result, some women who suffer from vaginismus avoid romantic relationships and become withdrawn. Often this withdrawal is not voluntary and is marked by strong feelings such as loneliness. This favors affective disorders such as depression.

Shame and guilt are common consequences of vaginismus. In addition, self-esteem often falls. Post-traumatic stress disorder or other mental illnesses are possible if the vaginismus is due to trauma or other stressors.

Medical complications from vaginismus arise almost exclusively indirectly. The vaginismus can be so severe that certain gynecological examinations are not possible. If an affected woman then avoids a visit to the gynecologist, she may postpone the treatment of other complaints. This can lead to further complications, for example infections that are not treated early due to avoidance.

When should you go to the doctor?

Vaginismus is painful and can make normal sex life almost impossible for affected women. It is not assumed that vaginismus will get better on its own or that the woman will be able to develop mechanisms to deal with it unaided. Therefore, when the first cases occur, the gynecologist should be consulted immediately. Since vaginismus can occur in connection with traumatic experiences, a woman can also consult a treating psychologist if she notices the symptoms.

The visit to the doctor must not be made dependent on the age of the woman concerned or her sexual experience. It can be that vaginismus occurs in a young girl and she notices it during the first sexual experience – just as it can be that a woman suddenly suffers from vaginismus after childbirth because she has not processed the experiences of childbirth.

In some cases, problems with sexual intercourse appear without any recognizable cause, but that doesn’t mean that it can’t still be vaginismus. Only the gynecologist can recognize this, but the earlier vaginismus can be recognized, the sooner it can be treated. The duration of treatment will take some time, but the more time the more unpleasant experiences a patient with vaginismus has before her first doctor’s appointment.

Treatment & Therapy

An effective treatment of vaginismus depends on the trigger of the vaginal spasms. In the case of physical causes, these include, for example, the surgical splitting of a fixed hymen or the removal of a congenital septum in the vagina.

If there is a suspicion of a mental illness, a combination of effective therapy measures is often used to gradually reduce the frequency of seizures and the patient’s anxiety. The step of confiding in the doctor and partner often brings initial relief for those affected when they experience understanding for their situation. In the field of vaginal spasm therapy, particularly good results have been achieved with vaginal dilators. These are smooth, tapered rods of various sizes that the woman can use to gently dilate her vagina.

This treatment can be supported by classic relaxation methods or biofeedback, but also by targeted pelvic floor training, in which the woman can regain control of her own body by tensing and relaxing the muscles concerned. In the case of massive psychological triggers, accompanying psychotherapy is advisable, which serves to process the traumata experienced. In the case of serious effects on the partnership, special couple or sex therapies can be helpful against vaginismus.

Outlook & Forecast

Vaginismus prevents the affected person from having a fulfilling sex life. Unfortunately, painful vaginal cramps are a condition that will not improve on its own. Since the most common cause of vaginismus is psychological triggers, the condition cannot improve until the cause is identified and treated.

Depending on what is causing the vaginal spasms, it may take several sessions with a sex psychologist before the woman notices a noticeable improvement. Even if there is a purely physical cause or the emotional trigger can be improved through exercises and training with dilators, it takes time. With this method, the woman gradually inserts larger and larger objects into the vagina and works on consciously relaxing. Over time, this will allow them to have a normal and fulfilling sex life.

What can prevent the success of the treatment is pressure from your partner or yourself. It is understandable, but absolutely counterproductive if your partner or patient becomes impatient and puts yourself under even more pressure. In the worst case, this can aggravate the already existing vaginismus and reverse treatment successes that have already been achieved. Involving the partner in the diagnosis and treatment, on the other hand, ensures that they can develop understanding and contribute to improvement through patience.


Due to the multitude of causes and its sudden appearance, vaginismus is a disorder that can hardly be prevented. In the physical area, regular gynecological examinations and good hygiene are ways of early detecting or avoiding diseases that promote vaginal cramps. In the psychological area, it should be particularly important to consistently work through negative events related to sexuality or birth in order to counteract the development of vaginismus as a result of trauma.


After a vaginismus (vaginal spasm), individual follow-up care is often helpful. The reason for the cramping is important for the design of personal aftercare. Physical causes are looked after by the gynaecologist, psychological causes often require the trusting cooperation of doctor, psychologist, the person concerned and their partner.

The fear of another vaginal fight can significantly restrict a woman in her sex life and even be a reason for renewed vaginismus. Therefore, it is good to know the cause of individual vaginismus and to work on it. If there are certain positions during sexual intercourse that obviously trigger the vaginal spasm, you can simply do without them in the aftercare.

If the fear of penetration has become too great, the woman can gradually approach this situation again with a finger or a vibrator. There are often psychological reasons that are responsible for vaginal cramps. This is where aftercare should start very carefully. Talking to psychologists will help to cope with problems. Self-help groups offer an exchange with like-minded people.

Discussions with the partner contribute to better mutual understanding and reduce fears. The woman’s ability to relax should also be encouraged during aftercare. This is easily possible with progressive muscle relaxation or yoga.

You can do that yourself

In many cases, a vaginal spasm is due to a psychological trigger. Embracing this and accepting that there is no organic disorder is a good first step. In the case of physically caused vaginismus, for example due to a narrowed vagina or inflamed tissue, the cause must be treated.

A good way to gain more intimate body awareness and anatomical knowledge of the sexual organs is to follow a good pelvic floor muscle training program. There are group and home courses that can be completed with or without a partner.

Insofar as the vaginismus is not based on trauma of a psychological or physical nature, a suitable means of relaxation can be used, in which the affected person concentrates fully on himself and his body. In the case of situational vaginismus – i.e. a vaginal cramp that always occurs in the same situation – it can help to deal more closely with the supposed trigger.

Furthermore, masturbation exercises, in which the movement emanates from the vagina through movement of the pelvis, are said to have good results in overcoming vaginal spasms. Here it is important that the control emanates from the sex organ and not from fingers or the like. This teaches how the vagina behaves when penetration is attempted. Taking into account your own physical limits, these can also lead to a certain desensitization and stretching of the tissue if the vagina is too tight. However, the effect is limited if the sheath is too small.

Vaginismus (Vaginal Spasm)