The problems in the intimacy of the couple are of different nature, in addition a wide multiplicity of internal and external factors must be considered. In particular, certain medical and psychological problems can affect performance during sexual intercourse. One of them is vaginismus, which is not widely recognized today, however statistically the registered cases remain constant.

The most accepted meaning of this term describes a conditioning that causes the involuntary contraction of all the muscles of the pelvic floor. These are the ones that line the vagina, as a result there may be a partial closure or a total closure of the cavity. These changes prevent penetration causing a lot of pain.

It is a type of sexual dysfunction that is currently considered to be very common. Not only does it have repercussions in the life of a couple, it will also cause important changes in the woman’s self-esteem. Causes anxiety, frustration, and stress; but it is also one of the sexual pain disorders.

What is vaginismus?

Vaginismus is a very common medical term used to refer to pain during penetration of the male organ into the vagina. That is, it is a condition of a sexual nature that is characterized by the impossibility of achieving a pleasant penetration. Involuntarily there is a constriction, the muscles that are located in the vaginal cavity.

Technically the formal medical term used for sexual pain is dyspareunia. When it becomes a common problem during sexual intercourse, specifically during the act of intercourse, it is likely that orgasm will not be achieved. However, by applying certain techniques it is possible to achieve pleasure, with the help of your partner.

This condition can be subdivided into two categories: primary vaginismus and secondary vaginismus. Primary vaginismus is identified in women who have never had sexual intercourse or even some type of penetration. These are patients between the ages of 12 and 20 years. They start to notice when they try to use tampons, get a Pap smear, or start having sex.

Secondary vaginismus is diagnosed in women who have previously been able to achieve normal vaginal penetration. However, at some point in their sex life they suddenly became unable to do so. The causes can be psychological and physical, although the onset can be found in an untreated vaginal infection. Also the aftermath of gynecological surgery or childbirth.

What are your symptoms? 

Generally, women with vaginismus as the main symptom experience severe pain in the vaginal area . The same only manifests itself when it comes to penetrating, this means that it is a direct reaction to touch. However, in some cases there may be vaginal spasms that are not necessarily associated. They begin during the previous act, which indicates the nervousness and stress that this generates.

Sexual intercourse is painful for these people. The pain can vary in intensity and how it affects, in some cases it is a feeling of tightness while in others it is a stabbing pain. It can be accompanied by other sensations such as swelling, burning, or itching.

The discomfort becomes evident, making it difficult for even a light touch to begin to feel pain. At first it is not possible to identify an apparent cause for these symptoms, eventually it happens to cause long-term sexual pain. Penetration is difficult and even impossible to achieve, it depends on the intensity of the vaginal constriction.

Any attempt to achieve sexual intercourse is cut short by the body’s resistance to advances. This is the beginning of a cycle of constant pain that can also be accompanied by emotional anxiety . Women diagnosed with vaginismus often experience other psychological symptoms such as insomnia and depression for example.

What are your causes?

The causes for vaginismus are divided into two distinct groups: physical causes and psychological causes. They described below:

Psychological causes

Perhaps the most notable are the psychological causes, because they play a very important role during sexual intercourse. The mental state of both individuals should be conducive and allow the sexual act to be carried out with consent. 

In most cases, a high sensitivity to stress situations is observed , which causes involuntary contraction of the vaginal vestibule. The possibility that lack of experience is the cause of a state of nervousness can also be mentioned. Likewise, the lack of communication between both parties is another determining factor.

Unfortunately, mention should be made of sexual abuse and other types of traumatic experiences of a sexual nature. These patients must face the psychological consequences that these negative situations leave in the long term. Above all, those situations that occurred during childhood will have a greater impact, in the adult stage conflicts are created that must be treated with priority.

Some women are more sensitive to just thinking about what they will feel during sexual intercourse. The fear of pain itself is reason enough for the muscles to contract unconsciously. There is no doubt that there is a strong mental connection with everything that happens in the body.

Finally, strict religious upbringing and lack of information regarding sex should also be considered as contributing factors. People should be allowed access to information on this topic and to resources such as condoms. Maintaining an active and healthy sex life also depends on proper education.

Physical causes

As for the physical causes, the main one is inadequate sexual stimulation. In some cases it is observed that some women require more stimulation in this area to achieve natural lubrication. You can use the use of lubricants that significantly improve sexual performance and experience.

Attention should also be paid to health. Trying to have sex with a vaginal infection increases your chances of experiencing pain. Finally, poorly treated gynecological surgeries or that are still in the healing phase can also cause discomfort.

In some cases the abruptness or lack of sensitivity on the part of the partner during sexual intercourse is also a relevant cause. Both parties will need to maintain good communication to understand what your needs are. Both are supposed to experience equal parts pleasure.

In the case of women who are experiencing menopause, the probability of experiencing painful intercourse increases. The cause is found in the reduction of estrogen levels within the system. As a consequence, the tissues that line the walls of the vagina become thinner and less elastic. Likewise, lubrication in this area decreases.

What are its consequences?

Among its consequences, the couple problems that this condition generates stand out. It is associated with the feelings of frustration that both experience after the impossibility of being able to have a normal and healthy sexual life. Women can face rejection from their partners, especially since it is difficult to understand at first.

In some cases there is a lack of empathy in understanding that this is an uncontrollable and unconscious medical problem. The loss of communication in the couple is accompanied by feelings of guilt, fear, confusion and anger . Unfortunately, this is the beginning of a distancing that will eventually result in the definitive ending of the relationship.


For the treatment to be effective, the participation of multidisciplinary doctors such as gynecologists, psychologists and also a physiotherapist is contemplated . Each of these professionals will be in charge of solving different aspects of this condition.

The physiotherapist will be in charge of teaching the patient to perform exercises that improve the functioning of the muscles of the pelvic area. This is a condition that can be effectively treated by systematic dilation and desensitization treatments.

These are the most recommended resources for these cases, technically they are treatments for dyspareunia. It combines the use of physical techniques and psychological tactics that aim to reduce stress and anxiety. 

Also therapies couple achieve better communication and sex of the parties involved. The important thing is to understand that this is a condition that has an emotional background that should not be ignored. Systematic desensitization is not only applied to treat vaginismus, but also sexual dysfunction and phobias for example.

Because most patients present with this sexual dysfunction from a psychological problem, treatment will focus on treating past trauma or abuse . It is important to improve the mental health of the patient who is causing the physical pain.

It is important to clarify that this problem is not related to a loss of sexual desire. Instead, the patient can be helped to become aroused and desire by stimulation of the clitoris . It is recommended that the first sexual encounters reach orgasm using this technique.

The diagnosis at first can be complex because the information provided by the patient must be analyzed. The health assessment is carried out by a physical examination where the aforementioned contraction is verified. Other organic factors such as vaginal infections, endometriosis or even atrophic vaginitis should be ruled out .

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Alexa Clark specializes in Cognitive Behavioral Therapy. She has experience in listening and welcoming in Individual Therapy and Couples Therapy. It meets demands such as generalized anxiety, professional, love and family conflicts, stress, depression, sexual dysfunction, grief, and adolescents from 15 years of age. Over the years, She felt the need to conduct the psychotherapy sessions with subtlety since She understands that the psychologist acts as a facilitator of self-understanding and self-acceptance, valuing each person's respect, uniqueness, and acceptance.

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