Did you know that 1 in 20 women experience this invisible pelvic issue?
If sex feels painful or impossible, you’re not alone AND it’s not in your head. Vaginismus is real and very treatable.
In today’s blog post, we are chatting all things Vaginismus causes and treatment. A common but often misunderstood condition affecting women’s health.
Unlike other muscles, fascia, and ligaments throughout your body, your pelvic floor is, for the most part, invisible. You’ll never know it’s there, and probably don’t think about it functioning … unless something is wrong.
If you live in the San Jose area and experience pain with sex, exams, or insertion it might be Vaginismus.
What is Vaginismus?
First, lets dive into what Vaginismus is. If you know someone who has a vagina, chances are they – or someone they know and love – suffer from this invisible pelvic floor disorder.
- Vaginismus is an involuntary spasm of the muscles within the vagina upon penetration, or upon perceived *threat* of penetration. Resulting in an inability to have penetrative sex as well as an inability to insert a tampon or have a pelvic exam/digital insertion.
- Vaginismus is a drastically under-reported pelvic floor disorder that many people with vaginas experience, and unfortunately, no reliable numbers exist that accurately convey its prevalence.
- Vaginismus is more common than you think.
Put simply, we don’t know the exact number of people who suffer from this pelvic floor dysfunction condition because many people are ashamed of having it – even though it is not their fault. Many people don’t feel safe or supported in sharing their condition with their medical provider, so they suffer in silence.
If penetration hurts, or stops you when you try, you’re not alone. Vaginismus is more common then you think. Our pelvic floor physical therapists in San Jose can help women like you feel comfortable during a medical exam, use your preferred feminine products and/or be intimate with a partner. <<Get Help For Vaginismus>>
What Does Vaginismus Look Like?
Now that we know what Vaginismus is, lets explore what it looks like. It is very reasonable to assume that most people are unaware of the many muscles that comprise their vagina, so we have included a visual below to help us understand the scope of what Vaginismus entails.
Refer to the side view picture above. The left shows a typical vaginal opening flanked by pelvic floor musculature on either side of the opening. The opening is sufficiently sized so that penetration is feasible.
The right side shows a Vaginismus vaginal opening. It is much narrower, making penetration virtually impossible, due to the pelvic floor musculature on either side of the opening spasming.
The above picture shows this in a different way, so we can better visualize the exact pelvic floor musculature that is responsible for the vaginal opening and narrowing, the transverse perineal muscles.
Upon penetration, or mere *threat* of penetration, these muscles involuntarily spasm and contract, making the opening extremely narrow and preventing any type of penetration or insertion.
Because these muscles aren’t easily visible, many people don’t always know or understand what is happening when they are experiencing symptoms. They say it feels like something is “hitting a wall.”
Having a visual is helpful to understand exactly what is happening in your body so you can make an informed decision about how to treat it.
Why Does Vaginismus Happen?
Now that we are well-versed in what vaginismus is and what it looks like, it’s helpful to explore what causes vaginismus.
Vaginismus has a multi-factorial etiology –in other words, many causes. Some causes are physical or medical, while others are more psychological or psycho-social in nature. And for some, it’s a combination of everything.
Causes for vaginismus may include but aren’t limited to the following:
- Previous medical conditions or surgeries: Multiple urinary tract infections (UTIs), sexually transmitted diseases (STDs), and yeast infections can result in a higher risk for developing vaginismus. If you’ve had surgery to the genital or pelvic area, that may also result in vaginismus.
- Hormonal changes concurrent with aging: As our bodies age and our hormones fluctuate due to childbirth, menopause, or using hormonal contraceptives. Our risk of developing vaginismus changes over time as well.
- Perineal scarring or tearing: After giving birth vaginally, some people develop vaginismus, likely due to perineal tearing and scarring.
- Trauma: People who have experienced sexual trauma or sexual abuse during their life have an increased risk of developing vaginismus.
- Anxiety and Fear: People who suffer from anxiety, fear or other high emotive states around sex and penetrative intercourse may have an increased risk of developing vaginismus.
- Cultural and Religious Influences: Cultural and religious factors can create negative attitudes towards sex and also play a role in the development of vaginismus.
In addition to the aforementioned causes, it’s important to differentiate between primary and secondary vaginismus.
Primary Vaginismus
Folks who have primary vaginismus report that they have never been able to endure vaginal penetration.
People who experience primary vaginismus discovered they cannot experience vaginal penetration under many circumstances. This includes but is not limited to the following common scenarios:
- When trying to use a tampon,
- When a practitioner is trying to administer a pelvic exam by using a speculum or gloved finger
- When they are trying to have penetrative intercourse.
Secondary Vaginismus
In contrast, people who have secondary vaginismus report that earlier in their lives, they were able to endure or experience vaginal penetration. Later in life, though, they are no longer able to experience vaginal penetration. Oftne reporting involuntary vaginal muscle spasming sensations.
Something happened between these two phases in the person’s life resulting in secondary vaginismus.
Vaginismus and Pelvic Floor Physical Therapy
For so long, mainstream medicine has been dismissive of anything pertaining to or labeled as “women’s health.” This has led many people to minimize their pain, disregard their symptoms, and tragically, not advocate for themselves. Instead, many women live a life beset by pain and discomfort because they feel they have no choice.
For a long time, unfortunately, people who experienced vaginismus were told by their providers that their pain “was in their head,” that they should simply “use more lube” to rectify their penetrative or intercourse pain, or worse yet, that their pain was unimportant.
With the emergence of pelvic floor physical therapy there are now medical providers who are experts in the functioning of all aspects of the pelvic floor, including the muscles that constitute the vagina.
Optimize Pelvic Health is the leading pelvic floor physical therapy clinic in San Jose specializing in the treatment of Vaginismus. Our Pelvic floor physical therapists understand that while it may be “common,” it 👏 is 👏 not 👏 normal 👏 to experience pain with vaginal penetration at any stage in life. Just because something is “common” does not mean it is “normal.”
How Pelvic Floor Physical Therapy Helps Vaginismus
At Optimize Pelvic Health, our pelvic floor physical therapists use a gentle, trauma informed approach to get to the root causes and develop specialized treatment for Vaginismus. This includes targeted pelvic floor stretches and relaxation techniques. These stretches help to lengthen and soften muscles that have been gripping and guarding due to chronic tension, fear, and past trauma. We also guide you through breath work and body awareness that retrain your nervous system to feel safe during movement and touch.
As part of treatment, we may introduce dilators. They are smooth, medical grade tools that comes in graduated sizes. When used with medical guidance, dilators are used to retrain your muscles and nerves to feel safe with insertion. This will help reduce pain and gradually improve trust with penetration. You will learn how to use them at your own pace and comfort level.
Additionally, we address factors not commonly discussed such as stress nervous system and organ guarding.
<<Learn more about how stress ad organs impact vaginismus.>>
Connect with a Pelvic Floor Physical Therapist for Vaginismus Support
You don’t have to live with pain, discomfort or fear during penetration. Vaginismus is treatable and the right care can help you feel safe in your body.
You – and your health! – are worth it.
You don’t need to live in pain and discomfort for the rest of your life.
You *can* enjoy vaginal penetration.
Vaginismus can feel isolating but it’s absolutely treatable. At Optimize Pelvic Health, we specialize in help women through expert pelvic floor therapy that addresses the physical tension and the underlying stress signals that keep the body on guard.
If you’re in the greater San Jose area and ready for care that goes beyond treating the surface, schedule an evaluation today.
FAQs – Understanding Vaginismus Causes and Treatment
Vaginismus is an involuntary tightening of the vaginal muscles, often triggered by fear, pain, or anticipation of discomfort during penetration.
For some, symptoms may lessen over time, but lasting relief typically requires gentle treatment like pelvic floor physical therapy.
Treatment includes pelvic floor physical therapy, desensitization techniques, education, and nervous system regulation. No surgery is required.
While it is common, it is not normal. Pain with intimacy may be related to Vaginismus and should be evaluated by a medical professional such as a pelvic floor physical therapist.
If you’re in the San Jose area, Optimize Pelvic Health specializes in trauma-informed, whole-body care for Vaginismus
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