In this guide on “Vaginismus,” also referred to as vaginal spasm, I explain its causes, diagnosis, background, and treatment options. As a midwife and sexual therapist, I have seen that most women mainly want to get rid of the physical symptoms. However, for lasting results, it is crucial to address the underlying causes. For women who are primarily looking for the best product to treat symptoms, I recommend the new FMS Dilators, whose design and function are based on my extensive experience as a midwife and therapist. As certified medical devices, their effectiveness has been proven. Numerous positive reviews confirm the exceptionally fast success of this treatment. Women who are still seeking information will find all the essential facts here: definitions, causes, and treatment of vaginismus.

Table of Contents:

What is vaginismus?

Vaginismus, also called vaginal spasm, describes the involuntary contraction of the pelvic floor muscles. For affected women, it feels as if the entire vagina cramps painfully. It is classified as a sexual dysfunction and can significantly impair quality of life. Everyday activities such as using tampons or menstrual cups, undergoing gynecological exams, and especially sexual intercourse become difficult or impossible. Male partners often suffer alongside due to the impact on intimacy.

Vaginismus is not the same as dyspareunia. Distinguishing between the two is challenging even for many healthcare professionals. I have prepared a dedicated guide on dyspareunia.

Causes of vaginismus

Unlike dyspareunia, vaginismus rarely has physical causes. Different forms are recognized, but they are almost always rooted in psychological factors. Common triggers include fear of penetration – whether by a penis, finger, or other objects – and issues related to female identity. These often trace back to childhood, where the girl may not have perceived herself as a female being, influenced by parental attitudes toward the body and femininity.

Symptoms of vaginismus

The intense fear of penetration leads to a painful, reflexive pelvic floor spasm. This fear is emotionally exhausting and, combined with the spasm, can occur even without an immediate trigger. A vicious cycle of fear, tension, and pain develops. It is essential to break the taboo around this condition and approach therapy holistically – addressing physical, psychological, and sexual aspects.

How long does a vaginal spasm last?

As with any muscle cramp, the duration varies by individual and situation, lasting from a few seconds to several minutes. While prevention is difficult, during a spasm, relaxation techniques, deep breathing, and consciously releasing tension in the body and mind can help ease the discomfort.

Vaginismus Type I and Type II

Vaginismus Type I

This type is also called phobic vaginismus. It is characterized by an intense fear of vaginal penetration. A distinction is made between primary vaginismus, where symptoms appear before any sexual intercourse, and secondary vaginismus, which develops after traumatic sexual experiences. In these cases, vaginal exams or penetration are usually impossible. Some women still experience sexual arousal, while others do not. A desire for children may or may not be present.

Vaginismus Type II

This type is linked to identity-related issues. These women often have difficulties embracing their female identity. There is often a diffuse fear of motherhood, and they may use multiple contraceptive methods simultaneously when engaging in intercourse. Here, the fear is less about penetration and more about "expulsion," such as childbirth. While sexual intercourse may be impossible, gynecological exams are often tolerable. Physical causes can also play a role, such as rigid hymenal tissue or anatomical variations like a vaginal septum. Other triggers include infections, hormonal changes, or pelvic floor dysfunction.

Secondary vaginismus is usually linked to psychological factors like traumatic sexual experiences, negative childbirth experiences, or an upbringing that suppressed or devalued sexuality. It can also arise after menopause, surgeries, cancer treatments, or sexually transmitted diseases. These experiences can create both emotional numbness and deep-rooted fears.

Diagnosis

The diagnosis of vaginismus, dyspareunia, or vulvodynia (hypersensitivity of the vulva) is primarily based on a woman’s description of symptoms, her medical and sexual history, and childhood experiences. A gynecological exam is performed to rule out anatomical issues. However, such exams are often extremely painful or intolerable for women with vaginismus, which is why finding an experienced gynecologist is crucial.

To ease the fear of penetration during exams, the patient can maintain as much control as possible – for example, sitting upright in front of a mirror, observing the process, and even guiding her own or the doctor's gloved, lubricated finger. The doctor should always explain every step, move slowly, and ask for constant feedback to minimize pain and anxiety. The vaginal response often confirms the suspected diagnosis of vaginismus or vulvodynia.

As a helpful tool for gynecological exams, you can bring glass dilators in an appropriate size. Gentle pre-stretching can also help with everyday activities like inserting tampons or applying creams (e.g., for vaginal flora issues or lichen sclerosus). FMS Dilators, made from highly durable borosilicate glass, are superior to silicone dilators thanks to their smoother surface, quick cleaning, and optimal hygiene. Always use a high-quality lubricant for the best results.

What helps with vaginismus?

For many women, acknowledging vaginismus and seeking help is a major challenge due to shame and the impact on relationships. Professional counseling is key, especially regarding sexual activity with a partner.

Treatment usually combines several approaches. First, potential physical causes must be ruled out (see “Diagnosis”). If none are found, therapy focuses on the psychological aspects. Choosing the right psychotherapist or therapy method is crucial. Additional practices include relaxation techniques, body awareness exercises, gentle exploration of the vulva and vagina, and positive, self-directed erotic touch – always at a pace that feels safe and pressure-free.

Challenges for partners

Vaginismus, vaginal spasms, dyspareunia, or vulvodynia can be extremely stressful for couples. Male partners may experience situational erectile dysfunction. Open and honest communication is vital. I also offer professional support as a certified couples therapist to prevent the relationship from suffering.

Erotic treatment with a partner

Using FMS Dilators with a partner can also be part of an intimate, erotic experience. Their unique design allows gentle, penetration-like movements. More about FMS Dilators for couples can be found under Use for Couples.

How common is vaginismus?

Due to the high number of unreported cases, there are no reliable statistics. Studies suggest that between 4% and 42% of women experience vaginismus or occasional vaginal pain. Even if the true figure lies in the middle, about 20% of women are affected at some point. You are not alone.

Support groups

Exchanging experiences with other women in support groups can be very helpful. Be cautious online, as some so-called personal stories may be disguised advertising. Always verify the authenticity of such resources. Ideally, you can find a real-life group in your area, although that is not always possible.

Effective help with FMS Dilators

With 27 sizes starting at 14 mm in diameter and various sets, FMS Dilators offer the most comprehensive range worldwide for vaginismus, painful intercourse, and other vaginal or rectal conditions. Our Vagina Stents can help maintain long-term results.

"FMS" stands for Flexibilization and Massage System.

Unlike traditional dilators, they focus less on stretching and more on gentle flexibilization of the muscles through movement.

Innovative shape, premium material

As shown in the image, FMS Dilators are not cone-shaped. The streamlined tip glides smoothly into the body, while the straight shaft prevents tissue compression. Made of borosilicate glass, they are exceptionally smooth and hygienic.

Certified medical product

FMS Dilators are certified medical devices, ensuring safe and clinically proven use.

Warm or cool use

FMS Dilators can also be prepared as warm or cool elements. Heat is especially beneficial for vaginismus, as it helps relax the vaginal muscles. To maintain results, follow up with Vagina Stents for long-term support.

More resources

Additional articles on vaginismus:

• Theros® Vagina Stents for long-term use

Other guides:

• Pelvic floor and vaginal training with balls
• Kegel balls: Benefits, use & differences
• Kegel balls for post-pregnancy pelvic floor recovery
• Hemorrhoids: Causes, remedies & treatment
• Hemorrhoids after pregnancy and birth
• Anal fissure: Symptoms & treatment
• Lichen sclerosus: Causes, symptoms & treatment