Vaginismus impacts arounf 5% to 17% of people with vaginas (Picture: Getty)

Women’s health, and especially women’s sexual health, is still critically under-researched.

It can lead to some conditions being misunderstood or, worse, stigmatised, not only by those dealing with them but also by GPs and other medical professionals.

Not to mention the general consensus that everybody is having great penetrative sex all of the time, which can make people with sexual health conditions like vaginismus feel incredible alone.

Vaginismus, despite impacting some 5% to 17% of people with vaginas, is rarely discussed. 

Recently, there has been some attention drawn to the condition – with Meghan Trainor speaking out about her own experience, as well as it featuring as a storyline on season 2 of Netflix’s Sex Education,

But, for the most part, it’s still shrouded in mystery. 

Metro.co.uk spoke with Dr Katherine Hertlein, a world-renowned couples therapist and sexuality educator, to demystify the condition.

What is vaginismus?

Vaginismus is a condition whereby the vaginal muscles tighten involuntarily before and during penis-in-vagina (PIP) sex. 

It’s thought to be psychosomatic, meaning it’s a physical illness aggravated by a mental factor, such as internal conflict or stress.

‘It’s caused by the body’s automatic reaction, which can be induced by [a subconscious] anxiety or fear of penetration,’ Dr Hertlein tells us. ‘Although it’s most common during penetrative sex, it can happen before inserting a tampon or when being touched around the vaginal area.’

Importantly, there are two types of vaginismus: primary vaginismus and secondary vaginismus. 

‘Primary vaginismus occurs if you’ve never been able to have sex because of the condition while secondary vaginismus is the term used to describe the condition if you’ve been able to have sex before without problems, but it has since become impossible or difficult,’ says Dr Hertlein.

‘Identifying whether it’s the former or the latter is important in diagnosing the condition as it will enable you to understand your condition better and find which course of treatment will be most effective.’

It’s thought that vaginismus is a psychosomatic condition (Picture: Getty Images)

What causes vaginismus?

‘Studies have shown that there are no physiological causes of vaginismus, meaning it’s a psychological-based sexual dysfunction,’ says Dr Hertlein.

‘Vaginismus can be caused by many different factors, such as a past sexual experience that was negative, a belief that sex is shameful or wrong, the belief that your vagina is too small for penetrative sex, or a negative experience with a medical examination or previous operation within the pelvic area.’

Essentially, the causes can vary, as can the effects. 

What are the impacts of vaginismus?

Vaginismus can make PIP sex uncomfortable, painful or even impossible, which may result in reduced sexual pleasure and reduced sexual desire. 

Living with vaginismus can make intimacy difficult to navigate and can cause many people to feel self-conscious when it comes to sex, especially with new partners.

It can also cause self esteem issues but, says Dr Hertlein, ‘it’s important not to suffer in silence.’

What treatments are available?

‘If you’re struggling with this condition, it’s important to talk and find someone who can give the proper advice,’ says Dr Hertlein. ‘Do not let your condition be diminished.

‘Usually, your GP will act as a gateway to further treatments, so ask to be referred to a therapist that specialises in sexual health, as they can offer life-changing methods of support.’

These are the main treatments for vaginismus, broken down by Dr Hertlein.

Psychosexual therapy

Psychosexual therapy is used to treat underlying, subconscious thoughts and feelings that you might have towards sex.

The treatment is designed for you to identify and understand the thoughts that are associated with the tightening of the vaginal muscles.

It will also work to address the thoughts, and attitudes that you have towards sex and relationships.

Relaxation techniques

When muscles contract around the vagina, it’s usually caused by an uncontrollable muscle spasm in relation to your anxiety.

Relaxation techniques can work to relax your body before penetrative sex and enable you to reach a state of calm, where you feel comfortable with penetration.

Exercises for your pelvic floor

Pelvic floor stretches are sometimes advised for those suffering from vaginismus as they can help to loosen the muscles around the pelvis area. 

These can help those experiencing the condition to regain some control of their muscle contractions.

Sensate Focus

Sensate Focus is a technique designed to help you relax and overcome anxieties around sex. 

The technique can also help with low libido. 

It focuses on gradually building up to the sexual experience at a pace that the person is comfortable with, through a series of guided steps that focus on touch.

Vaginal dilation with ‘trainers’

Vaginal trainers are tampon objects used so that those experiencing vaginismus can gradually become used to objects being inserted into the vagina. 

The trainers gradually increase in size so you can begin to feel more comfortable with penetration.

Dr Katherine Hertlein is a world-renowned couples therapist, sexuality educator, and expert advisor at Blueheart.

Do you have a story to share?

Get in touch by emailing [email protected].

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‘Do not let your condition be diminished.’