Vaginismus: How Can Sex Therapy Help?

By Adrienne Bairstow, MSW RSW

Individual, Couple and Sex Therapist

Vaginismus refers to the involuntary contraction of the vaginal muscles that occurs when attempting to insert something into the vagina.  This may occur with intercourse, tampon insertion or pelvic exams.  Women and their partners often describe it as if they are hitting a wall or barrier when attempting entrance into the vagina. Vaginismus causes pain and in some cases it may make intercourse impossible.  Vaginismus may be lifelong (the woman has always had this response) or acquired (the woman was previously able to have intercourse without muscle contraction and without pain).

Vaginismus is a learned reflex.  This means that it occurs when a woman comes to associate intercourse or vaginal insertion with fear or pain.  Her body then automatically reacts to protect itself, by contracting the vaginal muscles.  In describing vaginismus, the analogy of the eye is often used: we’ve all been poked in the eye with a finger at some point, and now our eye automatically shuts when we see a finger coming.  Vaginismus is a similar response that cannot simply be willed away—telling a woman with vaginismus to relax will not eliminate the problem.

Pelvic floor physiotherapy can help by releasing muscles that may be causing the contractions and by teaching the woman how to control the vaginal muscles. Some women may also benefit from sex therapy.

Often when a woman experiences pain during intercourse, as with vaginismus, she comes to associate intercourse with pain and disappointment.  A woman with vaginismus who is unable to have intercourse due to pain may feel guilty for disappointing her partner, and may also resent her partner if the partner shows their own disappointment.  Some women start to avoid sex, and even avoid kissing and touching for fear that it will lead to sex.  Often, women and their partners have difficulty talking about the issue and helping each other through the challenges of vaginismus.

Sex therapy helps couples talk about their sex life and the impact vaginismus has had on their relationship.  Often both partner have been hurt by vaginismus, and sex therapy allows partners to move past this hurt.  With homework assignments and specific strategies, sex therapy helps couples rediscover passion and pleasure.

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