Vaginismus explained

Vaginismus is the name given to a rare condition in which sufferers experience vaginal tightness, causing discomfort, burning, pain, penetration problems, or a complete inability to have intercourse. It’s a very complex condition with both physical and psychological manifestations - and many women suffer in silence.

“It’s difficult to say how common vaginismus is because many women don’t like to talk about it,” says Professor Steve Robson, Vice President of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists. “I would estimate that about two or three women out of every 100 will experience it during their lifetime.” 

“Vaginismus is most often a nerve reflex, triggered by a painful problem. Some women will experience vaginal pain – from an infection, after birth, or painful intercourse – and the condition begins after this.  

“Some women will have other medical conditions, such as endometriosis or chronic infection of the Fallopian tubes,” explains Professor Robson. 

For Rebecca-Jo Lewis, vaginismus came out of the blue. “All of a sudden it just really hurt when my husband penetrated me. I went to the doctor and she referred me to a gynaecologist, who was able to diagnose me,” she says. 

Rebecca-Jo tried several treatment options, including the use of dilators, physiotherapy, naturopathy and kinesiology. “It made me feel crap and in a way I was a little depressed. I think I have a low sex drive now, as I just know it will hurt when we do it,” she says. 

It took Rebecca-Jo and her husband 18 months to conceive their son. “As it hurt so much, we hardly ever had sex, maybe a few times a month. I guess we had a magical month and our son was conceived.” 

After much research and deliberation, Rebecca-Jo decided to have a caesarean. “I came to the conclusion I had a 50/50 chance; my condition would either get better or worse,” she explains. 

“I just couldn’t risk it getting worse.” 

Despite longing for a vaginal delivery, vaginismus sufferer Laura Cornell^* also gave birth via caesarean. “As I got closer to having the baby, problems started to occur. I was having contractions at the right time and intensity as someone in labour. After lots of discussion, my obstetrician convinced me and my husband that a c-section was the best route.”

“At the time I felt really hurt by the idea because I’d always had a vision of delivering vaginally,” Laura says. But she’s optimistic about the future, saying, “I am hoping to resolve my vaginismus and go on to have another baby.”

It is possible to for vaginismus sufferers to have a vaginal birth. The hormones released during labour trigger the dilation of the woman’s cervix, and as the baby is pushed out, her vagina is opened and stretched.

But women suffering from vaginismus are advised to seek treatment before starting a family, as internal scans and examinations may cause some difficulty, both physically and emotionally. 

Dr Lisa Phillps-Leece is a clinical psychologist with a special interest in fertility, pregnancy and birth. “The treatment of vaginismus is usually a therapy program with a qualified sex therapist,” she says. “Counselling and psychotherapy are also very efficient. Psychosexual education is important as it is essential that the woman gains knowledge of her sexual anatomy.”

“Women who suffer from vaginismus are often raised in moral or religious homes, schools or institutions and, after a childhood of anti-sexual messages, it can be very difficult to face sexual interaction and accept sexual pleasure, even within a loving relationship.

“Physiotherapy can help train the vaginal muscles to relax.”

If you are concerned about vaginismus, it’s important to seek treatment. “If you’re fobbed off by a doctor, insist on seeing someone else. Often, sexual health or family planning clinics are a good place to start,” advises Professor Robson.

“The outlook is good and help is usually available”.

^*Name has been changed.