What is Vaginismus?
"Vaginismus" is the perception that sexual intercourse is painful and impossible by involuntary contraction of the muscles at the entrance of the vagina. These contractions can be triggered by merely imagining sexual intercourse, except for an actual sexual act.
With the involuntary contraction of the pelvic floor muscles, that is, these muscles surrounding the vagina, women with vaginismus and their partners may feel the vaginal entrance as a wall during sexual intercourse. During sexual activity attempts, pain, tearing, burning or stinging may be felt at the entrance of the vagina. Attempts to insert anything (finger, penis, etc.) into the vagina can be perceived as a painful act. A panic attack-like situation may occur at the same time.
In vaginismus, there may be contractions not only around the vagina but also in other muscle groups. jinimusta sadece vajen etrafında değil diğer kas gruplarında da kasılmalar olabilir. As a result of anxiety, fear and panic, the patient closes her legs tightly, pushes her partner and protects herself by contracting her whole body. These women, who think that the hymen will bleed too much, will burst, will hurt a lot during tearing, that their hymen is too thick or that their vagina is too narrow, try to protect and defend themselves as a result of the expectation of pain, and vaginismus develops.
Although the vaginal opening is flexible enough to allow the male's penis to be captured and even to deliver the head and body of a baby during normal birth, women with vaginismus are concerned that they will feel pain during sexual intercourse; therefore the pelvic floor muscles involuntarily and tightly contract, closing the vaginal entrance and making it impossible to unite.

Why does vaginismus occur?
Vaginismus is when the body contracts the pelvic floor muscles surrounding the vagina with the instinct of protecting itself during sexual intercourse and preventing it. The muscles surrounding the vagina contract completely involuntarily. The reason for this situation is "fear of pain". So for women with vaginismus, sexual intercourse always evokes pain and discomfort. The reason for this pain may be related to the pain and discomfort felt at the entrance of the vagina in the first sexual act of the person, as well as an imaginary perception of pain and discomfort that has never been experienced before. Due to this perception, the contraction of the pelvic floor muscles narrows the entrance of the vagina and really causes the woman to feel pain and discomfort. The main cause of vaginismus is the inaccurate and incomplete information that the person heard from his family and his environment and placed in the subconscious at the time of sexual identity. Most women with vaginismus do not know about the structure and location of their own genitals. Ignorance lies behind the worries of those who think that the penis will tear their vagina, that it will be squeezed inside, that it will enter the wrong place, that it will be locked during sexual intercourse, that it will feel too much pain when the penis is inserted, that the hymen is too thick, that their vagina is too small, that it will bleed too much. Thus, it develops a negative attitude towards genitals and sexuality.
Vaginismus may develop later in women who previously had a normal and healthy sexual life. Pain and discomfort during gynecological examination, scar tissue due to normal birth stitches, vaginal infection, wound, painful sexual intercourse due to irritation, abuse and rape leave negative marks in the woman's life and may cause the development of vaginismus.

How is Vaginismus Treated?
It is the involuntary contraction of the vaginal muscles of the woman (which I emphasize, so that the spouses or partners can hear this), and the inability to have intercourse or strain due to this. These contractions are not just during intercourse. Sitting at that table when they go to the gynecologist and obstetrician for examination is the biggest problem for those who have this problem. The doctor's examination is a bigger problem.

Primary Vaginismus
It is the inability to have sexual intercourse even once, which is seen from the beginning of sexual life.

Secondary Vaginismus
Secondary vaginismus occurs if intercourse is not possible while maintaining a healthy relationship or having difficulties after an event (birth, abortion, examination, rape).

Many factors can cause vaginismus, such as:

  • Sexual harassment, rape
  • Psychological trauma
  • Gynecological examination, childbirth, abortion, miscarriage
  • Pain in the first intercourse
  • Religious beliefs, traditions and customs, morals, taboos
  • Fears
  • Community, environmental factors
  • Misinformation about sexuality
  • The idea that the hymen will hurt, bleed, pierce and burst

There are various methods used as treatment. Vaginismus is a common problem of men and women. First of all, this treatment should be attended as a couple. The doctor first performs a gynecological examination so that there is no underlying problem. The treatment period may last from a few sessions to 10 sessions depending on the severity of the disease. If the appropriate method is used, not being cured is not an option. Psychological support, muscle relaxation homeworks and vaginal entry exercises are recommended for couples. If these assignments are done as told, there is almost no failure.

  • Op.Dr. Zeynep Taşargöl
    Obstetrics and Gynecology Specialist

    You can send me your questions and comments about Vaginismus via this field. The answers provided are advisory. You need to be examined by your doctor for diagnosis and treatment.