Vaginismus: Symptoms, Causes And Treatment For The Condition Affecting Millions Worldwide

As Lily speaks about the condition in Netflix's Sex Education, here's what you need to know.

“I have something called vaginismus. My vagina’s like a Venus flytrap.”

Lily’s frustrated admission in the final episode of Sex Education will be all too familiar for many viewers of the Netflix show. Vaginismus – where the muscles around the vagina tighten when penetration is attempted – is thought to affect millions of people worldwide.

It’s not that Lily doesn’t want to have sex, but it feels as though her body has other ideas. While the condition is often associated with pain during sex, it can also become a problem when inserting tampons or undergoing gynaecological and pelvic examinations.

“It can disrupt or completely stop your sex life, and can lead to distress, a loss of confidence and relationship problems,” Aly Dilks, clinical director at The Women’s Health Clinic, tells HuffPost UK. “It may even prevent you from starting a family.”

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What are the symptoms of vaginismus?

The NHS states that the main symptom is tightening of the vagina, which can make penetration difficult or even impossible.

It can affect women in different ways. “Some women are unable to insert anything into their vagina because it closes up completely, while others can insert a tampon but are unable to have penetrative sex,” explains Dilks.

“Other women are able to have sex but find it very painful.”

Other symptoms can include: burning or stinging when the vagina is penetrated, an intense fear of penetration and pain which makes you avoid sex, and loss of sexual desire if penetration is attempted.

What causes it?

While it’s not fully understood why the condition happens, factors which can play a part in its development include:

:: thinking the vagina is too small

:: negative sexual thoughts (such as thinking sex will be painful)

:: previous sexual abuse

:: damage to the vagina

:: painful conditions of the vagina and surrounding area (for example, vulvodynia)

:: painful first intercourse

:: relationship problems

:: fear of pregnancy.

Treatment for vaginismus

Vaginismus can be treated, however its treatment will depend on the cause.

If there’s an obvious physical cause, such as an infection, it can be treated with medication, explains Dilks. If the cause is psychological, sex therapy may be recommended in the form of counselling or cognitive behavioural therapy (CBT).

“These therapies can help to address any underlying psychological issues, such as fear or anxiety and can tackle any irrational or incorrect beliefs that you have about sex and, if necessary, be used to educate you about sex,” says Dilks.

There is also a therapy method women can try at home with their partners, called sensate focus. This is where a couple agrees to not have sex for a number of weeks or months and, during this time, they touch each other’s bodies, avoiding the genital area.

“The idea is to explore your bodies, knowing that you will not have sex,” explains the NHS Choices website.

“After the agreed period of time, you gradually start touching each other’s genital areas, which should eventually build up to penetrative sex.”

Vaginal trainers - a set of smooth, plastic penis-shaped objects in different sizes - can also be used to help relax the vagina muscles. They work by gradually getting a woman used to having something inserted into their vagina.

Dilks explains: “The smallest trainer is inserted first, using a lubricant if needed. Once you feel comfortable inserting the smallest one, you can move on to the second size and so on. It’s important to go at your own pace, and it doesn’t matter how long it takes – whether it’s days, weeks or months.

“When you are able to tolerate the larger trainer without any pain or feelings of anxiety, you and your partner may want to try having sex.”

If you don’t want to use vaginal trainers, Dilks says you can try using your fingers instead.

You may also find that relaxation and exploration exercises help,” she says. “Having a bath, massage and breathing exercises are good ways to relax while you get to know your body.

“Your therapist may also teach you a technique called progressive relaxation. This involves tensing and relaxing different muscles in your body in a particular order. You can then practice tensing and relaxing your pelvic floor muscles before trying to insert your finger or a cone.

“If you reach the stage where you can put your finger inside your vagina, you can try to insert a tampon, using lubricant if needed.”

Botox injections may also help ease symptoms. When Botox is injected into a muscle, it blocks the signals sent from the brain which tell the muscle to contract.

“Botox targets the muscles involved by effectively disarming them and ensuring that they do not send panic signals throughout the body,” Dilks explains. “The body believes that there is no pain being experienced.”

It’s estimated that Botox can help to keep the muscle relaxed for anywhere between three and six months, after which it is hoped that the muscle will be able to contract normally without pain or spasms.

Vaginal laser rejuvenation is another option for treating vaginismus. NU-V, a type of laser treatment, has been shown to be “very effective” in treating the symptoms of vaginismus, Dilks adds.

Unfortunately Botox and vaginal laser rejuvenation aren’t available on the NHS, however both “have had very good results for many women”.

For women with endometriosis or damage caused by childbirth, surgery is a potential option. In the latter case, surgery may be carried out to enlarge the vagina, especially if scar tissue has been left blocking or restricting it.