Vaginismus. Sounds like Christmas. It isn’t.
Pronounced vaj-uh-NIZ-mus.
Vaginismus affects somewhere between 1 and 7% of women and people with vulvas worldwide and the numbers are likely higher, but due to stigma and medical misogyny it often doesn’t get diagnosed correctly, if at all.
Vaginismus is when the muscles around the vagina tighten involuntarily in response to something trying to go in, and that something isn’t only penetrative sex (BTW sex shouldn’t hurt unless you want it to) but could also be tampons, speculums and fingers, which can make it uncomfortable, painful or “like hitting a wall”.
And anyone with a vagina can have it. Which includes women, trans men, non-binary and gender diverse people who are unfortunately not always represented in the data.
A note on the diagnosis
It’s important to note that vaginismus has been dropped from the main diagnostic manuals, the ones doctors and psychs use to diagnose you. In the DSM it’s now genito-pelvic pain/penetration disorder (GPPPD), which merged vaginismus and painful sex (dyspareunia) into one diagnosis.
So essentially two people with the same diagnosis can be experiencing very different things.
But plenty of GPs and medical journals still use vaginismus. I use it because my clients recognise the word, and because GPPPD covers vaginismus plus other things, so naming it adds nuance to their experience and understanding, which leads to more accurate treatment.
Some symptoms
Cleveland Clinic has the clearest rundown of symptoms I’ve come across, so I’ve leaned on theirs here.
It tends to show up when:
You go to put a tampon in
Anything goes in during sex, a finger, a toy, a penis
You’re having a speculum exam or a cervical screening
The tightening isn’t something you’re doing on purpose, and it isn’t something you can talk yourself out of. For some people it’s a bit uncomfortable, for others it’s properly painful, and it might happen every single time or only now and then.
When it starts
For some people it’s been like this from the very first attempt at penetration. It may never have been possible, or never without pain.
For others it turns up later, after a stretch of pain-free sex. That can follow childbirth, pelvic or genital surgery, an infection, menopause, hormonal change, or a painful or traumatic experience.
If you’re thinking this sounds like me
The next step is seeing a GP you trust, and going in equipped to advocate for yourself.
Track your symptoms first. When it happens, where the pain sits, and how you’d describe it. Having it written down means you’re not searching for the words in your appointment, and you’ve got a reference point if you feel overwhelmed.
Written by Jassy Rennie
Jassy is a Sex and Relationship Counsellor and Somatic Sexologist at Felt Sense Therapy. She works with vaginismus, vulvodynia, sexual pain and intimacy, with individuals and couples- Book a session