Portrait Dr. Birte Nachtwey

What is Vaginismus?

Involuntary contraction of the pelvic floor muscles inhibiting vaginal penetration is called Vaginismus.

Common Causes of Vaginismus

It is thought to affect about 5 – 17% of the female population in clinical settings, but many women don’t consult, so numbers may very well be higher.

Since vaginal pain disorder (Dyspareunia) is in the same spectrum, the latest and widely used American diagnostic manual DSM – V has merged these two disorders into one called genito-pelvic pain/penetration disorder (GPPPD).

Common causes can be:

    • misconceptions or lack of knowledge about your vagina being too small or the penis/object too big
    • fear that you will suffer from vaginal injury
    • negative, painful and/or or shameful sexual experiences
    • not feeling secure and well with yourself and/or the person and/or situation
    • an underlying painful medical condition like an infection or rash
    • negative thoughts or beliefs about sex and/or yourself, the other person(s) and/or the situation

Fear or anxiety about vulvovaginal or pelvic pain in anticipation of, during, or as a result of vaginal penetration is the most common cause of the automatic muscle contractions and/or pain.

Fears can (but must not) also involve pregnancy, becoming a woman and/or mother and wanting to stay your parents little girl.

The recurrence or persistence of vaginismus OR vulvovaginal or pelvic pain during vaginal intercourse or attempts for at least 6 months officially leads to the diagnosis of GPPPD.

I wouldn’t recommend waiting that long if you are affected by this .

Vaginismus Symptoms

The muscle contraction of the pelvic floor is involuntary and you have no or little control over it. The muscles are often trying to protect you from anticipated pain and discomfort.

Penetration doesn’t only mean a penis, but can also mean fingers, tampons, dildos or other objects.

A pelvic exam to outrule very rare vaginal malformations or a septum is often not possible.

Vaginismus is not necessarily combined with arousal or orgasm difficulties.

This condition may always have been like that, meaning that you are a virgin, but it can also develop later in life.

Vaginismus & Sexual Therapy

Any underlying cause(s) need to be evaluated and dealt with. Therapy can involve learning more about your body, not just in theory, but by self – exploring your genitals and providing your brain with the necessary information to develop security and confidence and gain more control.

This will not explicitly be done in the sessions, but you will be instructed what to do when in privacy. Your experiences will be talked about to accompany and support your development and process.

The therapy can involve working with fears and beliefs as well as physical exercises.

It will in any case be tailored to you and your needs and goals for yourself.
It will not be necessary to have a pelvic exam by a GP or gynecologist until you feel comfortable with it.

How long therapy takes varies greatly and is hard to predict. It highly depends on the effort you put in it and what and how often you practice between sessions at home.

If you give it your best effort and are a bit patient and persistent, you are very likely to experience much improvement or complete cure of the symptoms.

Don’t hesitate to start resolving your situation and get help, better sooner than later. You and your life are worth it.

Portrait Dr. Birte Nachtwey