If you're experiencing pain during intercourse, or having difficulty inserting anything into your vagina, you may have vaginismus. But we're here to let you know that you're not alone, and there's hope for relief.
Vaginismus is a medical condition where the pelvic floor muscles (the muscles surrounding your vagina) involuntarily tighten, making penetration difficult or impossible. This condition can cause uncomfortable to extremely painful sensations, and many people living with it also suffer from a lot of fear, anxiety, guilt, and shame.
While the exact causes of vaginismus are still unknown, experts suggest that it can result from physical, psychological, and social factors. This includes physical, emotional, or sexual abuse, endometriosis, scarring or adhesions from previous gynecological surgeries, or a lack of sexual education. Pressure and expectations from society (for example, pornography), negative body image, low self-esteem, fear of giving up control, or relationship problems can also play a role.
Often it isn’t a single event, but the combination of different experiences that causes vaginismus. It’s important to know that while vaginismus can be trauma-related, it’s not necessarily the case.
But even though we’re not entirely sure of the cause of vaginismus, we’re much more sure about the treatment. Vaginismus is treatable in 90-100% of cases, regardless of the severity level. Treatment varies based on individual differences and goals, but it usually combines psychological and physical components to address fear, pain, and muscle tension simultaneously.
Creating a supportive environment for vaginismus self-treatment
For vaginismus self-treatment to work, it needs to be done in a comfortable and relaxed atmosphere, and you need to be in the right mindset. It's okay if you're feeling fear or anxiety about potential discomfort—it's a natural response. However, it's crucial to remember that these feelings, when left unchecked, can inadvertently reinforce the very cycle you're trying to break free from.
Importance of mental and emotional health
If you're dealing with vaginismus, it's important to know that your feelings and emotions can have a direct impact on your physical responses, especially when it comes to vaginal penetration.
The involuntary tensing of the pelvic floor muscles can make penetration very painful. Pain imprints on our memory to protect us, so it's natural to develop fear and anxiety around this. In fact, it’s your body’s way of protecting you from further harm. This fear and anxiety can actually lead to your vaginal and pelvic floor muscles tensing even more. This tension can intensify the pain and may prevent comfortable penetration.
It's a difficult cycle, but please remember that it's okay to feel scared or anxious. It's a normal reaction to pain and discomfort. But also know that understanding this cycle can be a first step towards finding ways to alleviate your symptoms and find a way out of this cycle of pain. You're not alone, and there is help available for you.
It's essential that you look after your mental and emotional well-being as you navigate through this journey. Overcoming the cycle you're experiencing with vaginismus involves more than just the physical aspect; it involves a gentle yet determined focus on your emotional health.
Tips for creating a comfortable and relaxed atmosphere
If you’re not in a comfortable setting where you can fully relax, your vaginal and pelvic floor muscles won’t either. Choose a space where there’s no chance you’ll be disturbed, and make sure you have a comfortable surface to lie on. Your bedroom is usually the best place for self-treatment.
Before you start any exercises, allow yourself some time to unwind. Create a calming environment, perhaps with soothing music or comforting scents, anything that helps you to relax. As you move through your exercises, gently guide your thoughts to a place of calm and positivity. This might seem challenging, especially in the beginning, but with time and practice, it can become more manageable.
Create a ritual that helps you relax for self treatment. This could include lighting scented candles, diffusing calming essential oils, drinking some hot tea, taking a bath or hot shower, or anything else that soothes you. Once you’re feeling relaxed, lie down comfortably, and practice deep, diaphragmatic breathing before you start.
Remember, it's perfectly okay if your emotions feel overwhelming at times. They don't signify failure; they're simply part of your human experience. Keep breathing, keep focusing, and remember that this process is about progress, not perfection. You are doing the best you can, and that's more than enough.
Self-treatment techniques for vaginismus
Most people can treat their vaginismus themselves from the comfort of home. There are a bunch of effective techniques you can try at home to help with vaginismus. Most people use a combination of physical and psychological techniques, based on their individual goals and feedback from a medical professional. Techniques include physical therapy exercises to help relax your pelvic floor muscles and psychological exercises to rebuild the connection between your mind and body, understand your fears and anxiety and overcome your pain. Vaginismus is a complex condition and research shows it is crucial to address fear, pain and muscle tension simultaneously to achieve lasting healing.
Pelvic floor exercises
An important aspect of overcoming vaginismus is the regular practice of pelvic floor exercises. These exercises teach you how to control the contraction and relaxation of your pelvic floor muscles. They can be a good preparation for dilator training. Some of the most effective pelvic exercises for treating vaginismus include child’s pose, pelvic floor breathing, pelvic floor drop and piriformis stretch.
Performing them daily can help women to regain control of the pelvic and vaginal muscles and prevent any unintentional tightening of the muscles during future penetration. If you’re feeling overwhelmed by the language or range of exercises that are available, there are pelvic floor specialists who can cater the learning plan to fit your needs. Online specialists are also available, allowing you to stay in control of your treatment journey and progress from the comfort of home.
Vaginal dilators are tube-like devices made of plastic or silicone that can help your vagina and pelvic floor muscles get used to the feeling of penetration. They come in sets of different sizes to help you gradually progress.
Vaginal dilators can help change the way your vagina and pelvic floor muscles react to penetration. The goal of vaginal training is not to stretch or widen the vagina, as this is actually not necessary. The purpose of using these dilators is to help you get used to the feeling of having something in your vagina. By starting with the smallest dilator and relaxing your muscles while inserting it, your muscles will eventually learn to stop spasming when penetration is attempted, leading to a reduction in pain. Plus, pain-free success with the smallest dilator can help reduce fear and anxiety, making penetration more comfortable.
Many people find that a lot of emotions come up when they’re doing dilator therapy by themselves, so you might also want to consider adding therapy to your treatment plan to help you address those emotions and optimize your chances of reaching your goals.
Feeling ready to try? Here’s our step-by-step guide for using vaginal dilators.
Mind-body relaxation techniques
These exercises are aimed at strengthening the connection between your mind and body. Sometimes, we are unaware of how the different parts of our body are working together. For example, deep conscious belly breathing exercises can relax abdominal muscles, which are directly connected to the pelvic floor muscles. Consciously breathing in and out of the belly is also highly effective to engage the parasympathetic nervous system, which reduces the stress hormones released into the body when it is tense.
Other mind-body exercises focus on the pelvic floor muscles directly. Progressive muscle relaxation for example, focuses on the communication between the mind and the vagina so you can leverage psychology to regain control over your pelvic muscles.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is the most researched form of therapy. It focuses on the relationship between thoughts, feelings, and behaviors. CBT usually involves efforts to change thinking patterns and behavioral patterns so they are more aligned with the wanted outcomes. This can be achieved by revisiting unhelpful ways of thinking, learned patterns of unhelpful behaviors etc.
In the case of vaginismus, anxiety and fear can play an important role in perpetuating the pain. CBT offers proven techniques to overcome this negative anticipation of pain, and make space for more positive thoughts. It is often combined with psychoeducation to help you reflect on your relationship with your body and with intimacy and how these perceptions might be playing a role in your vaginismus.
Holistic digital programs
One of the newest innovations in self-treatment for vaginismus is digital therapy programs. These are interactive online programs that combine physical and psychological components in an easy-to-follow format. They provide at-home solutions that can be used from a desktop or smartphone.
Shweta Gohil, a digital healthcare strategist, points out that traditional treatment options—like a mix of self-treatment, pelvic floor physical therapy, and psychotherapy—can be hard for some people to access due to time, cost, the fear of pelvic exams, feelings of shame and stigma.
Holistic digital programs make it easier to access help by bringing together clinically-proven techniques straight to you through an interactive app experience. Services like HelloGina connect you with a qualified coach who guides you through the evidence-based program, eventually progressing to using vaginal dilators and intercourse. Your coach will guide you through every step at your own pace, and they're just a chat away if you have any questions. The app combines pelvic floor exercises, dilator training, mind-body relaxation techniques and CBT, with the goal of healing both your mind and body.
In two studies, HelloGina was shown to significantly reduce pain during insertion, sexual fears and stressful thoughts. Vaginal insertion independent of sexual intercourse was also noticeably improved. It also significantly improved sexual satisfaction.
If you’re curious to learn more about this approach, feel free to fill our HelloGina’s health assessment, to see if they can help you reach your insertion goals.
When to seek professional help
It's not always easy to admit that you need help to overcome your vaginismus, especially if you're feeling shame or fear around the condition. But you absolutely don’t have to do it alone: We and other experts are here to support you every step of the way.
Recognizing the need for professional assistance
If you've tried a combination of pelvic floor exercises, vaginal dilators and mind-body relaxation techniques but are not seeing any improvements, it's likely time to see a specialist who can help you develop a treatment plan. Also, consider seeking professional help if fear and anxiety are stopping you from trying or consistently practicing self-treatment techniques. Therapists and coaches have proven to be very successful in helping people overcome their mental and emotional barriers to self-treatment.
Finding the right healthcare professional
Your gynecologist is always a good place to start, because they’re already familiar with you and your body. So start by asking your gynecologist if they're familiar with the condition. Some might not be and if that’s the case, you can ask for help finding a specialist and request a referral. If you're not ready to work with a professional in person, that's okay too! Digital therapy with coaching services can be a fantastic way to begin self-treatment while still having support, so you don't have to go through it completely alone.
Please visit Tight Lipped’s free resource guide to find a provider in your area.