Vaginismus is a sexual health condition under the umbrella of genito-pelvic pain/penetration disorder (GPPPD) that causes a vulva owner’s pelvic floor muscles to contract in response to attempted penetration, making penetration difficult, painful, or even impossible.

This condition can have many negative side effects, particularly when it comes to a person’s sexual health. Common side effects include burning or stinging pain during sex, difficulty with penetrative vaginal sex, difficulty with tampon insertion, and fear or anxiety around sexual activity. Nevertheless, there are steps that a person with vaginismus and their sexual partner(s) can take to improve their sexual health and sexual experiences.

Pelvic Floor Physical Therapy

Vaginismus is caused by overly tight pelvic floor muscles, so retraining the pelvic floor muscles is a good place to start with treatment. Pelvic floor physical therapists can teach patients exercises that help them to relax and release their pelvic floor muscles. When done correctly under the supervision of a trained professional, pelvic floor muscle exercises can improve the function of these muscles, allowing them to release in response to attempted penetration.

Relaxation Techniques

Mindfulness, breathing exercises, and gentle touch can help a person relax their pelvic floor muscles. Consistently incorporating relaxation techniques into a sexual routine may be helpful for people with vaginismus.

Dilators or Vaginal Trainers

Dilators, also known as vaginal trainers, are tampon-shaped devices that come in multiple sizes and can be used to gently open and stretch the muscles around the vagina. By using dilators daily and gradually increasing the size of the dilator used, a person with vaginismus can gradually become comfortable with having something in their vagina.

Sex Therapy and/or Group Counseling

Sex therapy and/or group counseling may be helpful for patients to work through any psychological components that may be contributing to or arising from their condition. Sex therapists can help patients and their partners develop strategies for enhancing their sexual experiences, limiting pain and discomfort, and communicating effectively with one another.

Botox® (Botulinum Toxin Type A) Treatment

Individuals who have worked with some of the aforementioned approaches and are still struggling with vaginismus symptoms might consider doing a Botulinum Toxin Type A (Botox®) injection treatment to temporarily relax the pelvic floor muscles around the vagina. This treatment for vaginismus is generally combined with vaginal trainers and/or pelvic floor physical therapy, so that the vagina can slowly adjust to increasingly larger objects while the muscles around it are relaxed from the Botox® injections.

Regardless of how long a person may have suffered from vaginismus, there is hope for improvement. Vaginismus can be a chronic condition requiring routine maintenance with all the described techniques, which is why it is important to talk to your health care provider about these and other potential treatment options.

References:

• (2021). Self-help guidance for vaginismus and pain with penetrative sex. https://policyonline.nhslothian.scot/Policies/PatientInformation/Self-help_guidance_for_vaginismus_and_pain_with_penetrative_sex.pdf
  
  
• (2021, February 10). Vaginismus. https://www.nhs.uk/conditions/vaginismus/#:~:text=Vaginismus
  
• Pacik, P.T., & Geletta, S. (2017). Vaginismus treatment: clinical trials follow up 241 patients. Sexual Medicine, 5 (2), e114–e123. https://doi.org/10.1016/j.esxm.2017.02.002
  
  
• Women’s Health & Research: Institute of Australia. (2015). https://www.whria.com.au/wp-content/uploads/2015/03/Vaginismus-template.pdf