Vaginismus is the involuntary tightening of the muscles surrounding the vagina that makes penetration painful or impossible.
Most people suspect they have Vaginismus based on the symptoms and received a medical diagnosis based on patient history and their description of the problem. Unfortunately, there is no definitive test. This can mean a diagnosis can be difficult to obtain due to fear, shame, or lack of knowledge by the patient. Or, lack of knowledge or bias by the physician. Vaginismus is one of the most misdiagnosed medical conditions.
Vaginal penetration should not be painful, though culturally we often believe that penetration, particularly sex, should/can be painful. Often, appropriate use of water- or silicone-based lubes help with most pain. If your pain seems to not go away, seek medical advice. If your physician seems dismissive of your symptoms, seek a second option.
Vaginismus can be discovered the first time a person attempts to insert a tampon or sexual vaginal penetration. Many people believe this could be the hymen and believing it can be something that is simply pushed past. The hymen is often misunderstood, and I encourage you to research the misconceptions that are often taught in our culture. Again, with appropriate lubrication, vaginal penetration should not hurt.
Vaginismus can also develop later in life, after having pain-free penetration. There is not one “cause” of vaginismus which can begin a lot of frustration. People have developed the symptoms of vaginismus after a series of yeast infections, urinary tract infections, in conjunction with endometriosis, cancer, general pelvic floor dysfunction, post-menopause, trauma to the pelvic floor, sexual trauma, surgery, giving birth, or none of the above.
Vaginismus is the involuntary contraction of muscles. However, the medical community do not fully understand why the muscles are contracting. Some theories include pain and/or inflammation within the muscles or in the surrounding tissue is irritating the muscles causing the contraction or tightening. This would explain Vaginismus developing after chronic infections or trauma. Another theory is the sympathetic nervous system or fight/flight response. One of the physical reactions that can happen when the fight/flight response is activated is tightening of the muscles around the vaginal canal. One of the hormonal reactions that happen with the fight/flight response is the release of cortisol into the body, which studies have shown to increase inflammation in the body which can result in pain.
The current studies show that 2 in 1000 people experience Vaginismus, and we also know that number is extremely under representative of the actual number of people who are living with this.