Intimate Wellness Institute

What is vaginismus?

Vaginismus is the involuntary tensing or contracting of muscles around the vagina. The vagina is part of the female reproductive system. It connects the lower part of the uterus (cervix) to the outside of the body.

These unintentional muscle spasms occur when something — a penis, finger, tampon or medical instrument — attempts to penetrate the vagina. The spasms may be mildly uncomfortable or very painful.

How common is vaginismus?

Many people may be too embarrassed to talk about the problem with their healthcare providers so the exact rate is not known. It is understood to be common, however.

Who might get vaginismus?

Vaginismus symptoms may appear during the late teen years or early adulthood when a person has sex for the first time. The condition can also happen the first time a person tries to insert a tampon or has a pelvic exam at a healthcare provider’s office.

Some women develop vaginismus later in life. It can happen after years without any problems. Spasms or discomfort may occur anytime there’s vaginal penetration. Or you may have them only at certain times, such as during sex or pelvic exams.


What causes vaginismus?

Healthcare experts aren’t sure why some people experience vaginismus. It can cause physical, psychological and sexual issues. Bladder infections, UTIs and yeast infections can worsen vaginismus pain.

Factors that may contribute to vaginismus include:

  • Anxiety disorders.
  • Childbirth injuries, such as vaginal tears.
  • Prior surgery.
  • Fear of sex or negative feelings about sex, perhaps due to past sexual abuse, rape or trauma.

What conditions are similar to vaginismus?

These problems can cause symptoms similar to vaginismus:

Vaginal atrophy — Lack of estrogen after menopause makes the lining of the vagina thinner and drier (vaginal atrophy).

Vulvar vestibulitis (provoked vestibulodynia) — This condition causes painful sex (dyspareunia). People may have pain from initial penetration throughout the entire experience.

What are the symptoms of vaginismus?

Signs of vaginismus include:

  • Discomfort or pain during vaginal penetration.
  • Inability to have sex or have a pelvic exam due to vaginal muscle spasms or pain.
  • Painful intercourse.
  • It is also common to have trouble moving your bowels or emptying your bladder with vaginismus

You should see Dr. Guerette and IWI if you have painful sex or pain while inserting a tampon. These feelings aren’t normal.


How is vaginismus diagnosed?

Your IWI team member will ask about your symptoms and your medical and sexual history. A specialized pelvic exam can help rule out other problems and confirm the presence of muscle spasms.


How is vaginismus managed or treated?

Vaginismus treatments focus on reducing the reflex of your muscles that causes them to tense up and to re-train your muscles to react normally. Treatments also address anxieties or fears that contribute to vaginismus.

Some standard therapies we offer include:

  • Topical therapy: Topical lidocaine or compounded creams may help with the pain associated with this condition.
  • Pelvic floor physical therapy: A physical therapist will teach you how to relax your pelvic floor muscles.
  • Vaginal dilator therapy: Vaginal dilators are tube-shaped devices that come in various sizes. Their primary purpose is to stretch the vagina. People with vaginismus use dilators to become more comfortable with, and less sensitive to, vaginal penetration. Your provider may recommend first applying a topical numbing cream to the outside of the vagina to make insertion easier.
  • Cognitive behavioral therapy (CBT): CBT helps you understand how your thoughts affect your emotions and behaviors. It’s an effective treatment for anxiety, depression and post-traumatic stress disorder (PTSD).
  • Sex therapy: Trained sex therapists work with individuals and couples to help them find pleasure again in their sexual relationships.


The Intimate Wellness Institute is the most specialized center for sexual issues in the region. Dr. Guerette and the IWI team are pioneers in researching and bringing new, safe and effective treatments to women and their partners who are struggling with sexual dysfunction and pain. Some of the advanced IWI therapies include:

Advanced Physical therapy. IWI has advanced physical therapy options including a revolutionary chair called Emsella that provides drastic improvement by simply sitting on a chair, fully clothed with no pain and no recovery.

Emsella Therapy: EmsellaTM Advanced Pelvic Floor Therapy: Emsella is a FDA-approved revolutionary treatment for pelvic muscle and nerve issues. The BTL EMSELLA treatment uses High Intensity Focused ElectroMagnetic Energy (HIFEM) to treat ALL the pelvic floor muscles. The improved pelvic floor muscles restore function and eliminate pain and enjoy normal daily activities. During each 28-minute session you sit comfortably on the Emsella chair while it generates thousands of supramaximal pelvic floor muscle contractions.  Each session is equivalent to doing 11000 pelvic floor exercises. The procedure is non-invasive, and you remain fully clothed throughout. No drugs are required and the most you will feel is a slight tingling during the treatment. With no recovery time needed you can leave immediately after each session and resume normal daily activity. The majority of people need a course of six sessions over a period of three weeks to see optimum results, with most people seeing and feeling results after just two or three treatment sessions.

Advanced injection Therapy: Dr. Guerette has developed protocols using anesthetic medication, Botox, steroids and other medications to isolate the pain and treat it in a safe, comfortable office-based procedure with sophisticated injection techniques.

Platelet-Rich Plasma (PRP): PRP is a simple, safe office procedure to isolate growth factors from your own blood and place them into the damaged area to restore the collagen, elastin, nerves and blood vessels in the pelvic tissue to regain motion, comfort and normal sensation. There is no recovery to this procedure.

Laser and Radiofrequency (RF) Treatments: IWI has the most complete suite of lasers and radiofrequency treatments to treat pain related to the vaginal lining, vulva and muscles in the pelvis. These are revolutionary 5-minute painless treatments with no down-time that can successfully correct the issue and require only a quick touch-up treatment once a year. IWI is the only practice in the region too offer women is option.

Extra-corporeal Shock Wave Therapy (ESW): Dr Guerette has pioneered the use of ESW to restore normal sensation, nerve function and blood flow to the nerves, muscles and other structures in the pelvis. This is a safe, painless office treatment with no preparation or downtime.

These therapies can be used alone but usually work best in combination to address all aspects of pelvic pain and painful sex.