Vaginismus is a condition in which an involuntary contraction of the pelvic floor muscles makes sexual intercourse difficult or impossible. It is a type of dyspareunia (which is pelvic or vaginal pain associated with intercourse); however, dyspareunia specifically relates to sexual pain, whereas vaginismus can also impede the use of tampons or prevent your gynecologist from performing an internal vaginal examination. The impact on quality of life can be substantial, particularly if you are in active sexual relationships. 

The taboo surrounding pelvic floor dysfunction can make it difficult to seek treatment due to embarrassment and lack of knowledge about the legitimacy of your condition. Working up the courage to speak to your GP can take time, and fear around having an examination may also deter you, introducing unnecessary delay in getting treatment. Vaginismus can leave you feeling helpless and isolated. 

The key point to note with vaginismus is that the contraction of pelvic floor muscles is involuntary. If you don’t understand that the condition is due to involuntary contractions, you may think that it’s your fault that your pelvic floor is contracting – IT’S NOT YOUR FAULT! Don’t even think for a second!! It’s also not your partners fault. A 2020 study found that treatment is less effective if you or your partner believes that it is his or your fault.

When you understand that the contraction of pelvic floor muscles is involuntary and know that it is outside your control, you may feel powerless. This site is all about helping you to empower yourself to overcome pelvic floor dysfunctions, including vaginismus, so in this article, we will explore some steps to help you overcome the condition.

The protective nervous system

If you have read our recent article asking the question if you should focus on length before strength with pelvic floor dysfunction, you will have learned that the management of both length and strength is governed by your nervous system. The nervous system utilizes both the musculoskeletal system and the connective tissue system to manage the balance of tension throughout your body. It is this balance of tension that dictates if you have hypertonicity (tightness) or hypotonicity (laxity).

The nervous system’s primary function is to protect you to ensure your survival. The protective responses from the nervous system would prove very useful if you were being chased by a saber toothed tiger – your heart rate and blood pressure would be increased to quickly ship nutrients out to major muscle groups so you could run quickly away, you pupils would dilate to ensure you can take in as much light as possible allowing you to see more of the environment around you. Your digestion is slowed so all of your energy can be used to get you out of that dangerous situation.

Indeed the survival of our species was insured by the ability of the human nervous system to elicit protective responses. Those protective responses are not just the “fight or flight” type responses to get you away from that saber toothed tiger. Your nervous system communicates with you continuously sending sensations to guide you towards survival. The feeling of hunger is your nervous system telling you to eat to survive. The feeling of being tired is your nervous system telling you to sleep. Pain is also a message from your nervous system, telling you to be careful. The nervous system really is amazing, but not without its flaws.

Two way communication

Unfortunately in it’s drive to protect us, the nervous system can also initiate unnecessary and unwelcome muscle contractions, such as those involved in vaginismus. Thankfully communication is not “one way”. We communicate with our nervous system through movement, actions and thoughts.

When you get a hunger signal from your nervous system and you eat – that is your message in response to that signal. When you work hard at the gym to grow your muscles, you are sending a message to your nervous system: you are saying “I need the strength to lift this heavy weight”. There is a constant back and forth of messages between you and the system that ensures your survival.

Step 1 – Combat negative thinking

Have you ever noticed a visceral response in your body when remembering a horrible event from your past? You nervous system cannot tell the difference between your thoughts and what is actually happening presently. This is important to know because of its implication – what you think can impact what physically manifests in your body. Changing negative thoughts you may hold towards yourself, your body, or sex and sexuality can send a positive “safety” messages to your nervous system encouraging it to let go.

If you have been to your doctor to discuss vaginismus, they may have suggested Cognitive Behavioral Therapy (CBT) which is a treatment often used to help with vaginismus.  I know when CBT was first recommended to me, I was offended as it felt as thought I was being blamed for my pelvic floor dysfunction. By understanding how my thoughts could impact what was happening physically, I was able to make my peace with this type of therapy and it helped me immensely.  The most simple form of CBT I have used is Byron Katie’s “the work”, which is a very effective way to address negative thought patterns.

Step 2 – Vaginal dilation

If you suffer from vaginismus, you may well have heard of vaginal dilation using dilators or “trainers”. So many people get in touch to ask about dilators for “stretching” the vagina. When you use dilators, it’s not so much about “stretching” the tissues. It’s more about communicating safety to your nervous system. I believe that it matters where, when, how and with whom you use dilators as all of these can have an impact on whether or not you feel safe:

  • Where – You should be in a place where you feel safe and comfortable.
  • When – It should be at a time when you feel you will not be disturbed or under pressure to “hurry up”.
  • How – Your body should be comfortable and supported, ensuring that your inner thigh muscles can relax.
  • With whom – Going solo is great, but it can also help to work on dilation with a loving trusted partner.

Dilators can range in size from baby-finger width to the size of a large erection. If you struggle with the smallest dilation, you can begin with a q-tip. You should also use lubrication if you are planning to use dilators. You can watch this YouTube video for more tips on vaginal dilation.

Step 3 – Pelvic floor relaxation exercises

Movement is a method to communicate with your nervous system. Yin Yoga is a form of yoga where you assume a position before allowing yourself to relax into that position allowing your connective tissue and muscles to gently stretch over a few minutes. Many yin positions target relaxation of the muscles of the inner thighs (your adductors) as well as the pelvic floor. Relaxing these muscles can help immensely when dealing with vaginismus and other conditions involving pelvic pain. You can use the exercises from our pelvic floor relaxation playlist on YouTube as another tool to communicate safety to your nervous system.

Step 4 – Finding the “on” switch for penetration

On our sexual dysfunction page, we explain the ingredients in the recipe for orgasmic climax: desire, arousal, and stimulation. When penetration has been a problem, it can be difficult to muster up the desire. It can be hard to feel aroused without desire. Desire and arousal both send safety messages to the nervous system so how can we get past the fear of penetration in order to feel the necessary desire and arousal? We have to flick the “on” switch, which is the clitoris!

Clitoral stimulation can help to turn “on” desire and arousal which can create the relaxation, the lubrication, and the opening needed for successful stimulation. In my opinion, sex education in schools should teach us about stimulation and climax, and not just explain penetration. It is important to know your body and to know what excites you. Self-stimulation (masturbation) is a great way to learn what works for you. It can also be really good to focus on clitoral orgasms with your partner without penetration to help build the trust that is inevitably needed to send that big safety message to your nervous system.

Step 5 – Reduce stress

This may seem obvious, but I will say it regardless. Reducing stress is one of the best ways to communicate safety to your nervous system. You can take up meditation practice such as yoga nidra to help reduce stress and relieve tension in your body. Practice mindfulness, practice yoga, get good sleep, avoid people that trigger anxiety in you. Anything you can do to help eliminate stress from your life will have a positive effect on your vaginismus.

One last thing

Above all else, believe in your ability to overcome your pelvic floor dysfunction. Know that you are not alone. You are part of a large community of women across the world who are choosing to empower themselves. Together we can and will make a difference.