Vaginismus - Treatment 

Treating vaginismus 

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Media last reviewed: 07/05/2013

Next review due: 07/05/2015

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Treatment for vaginismus will depend on what is causing it.

If there is an obvious physical cause, such as an injury, infection or vestibulodynia (oversensitive nerves at the opening of the vagina), this can be treated with medication at the same time that the vaginismus is treated.

Read more about the causes of vaginismus.

Sex therapy

If the cause is less obvious, you may be taught self-help techniques to try to resolve the problem.

Your GP will refer you to a healthcare professional who specialises in psychosexual medicine or sex therapy. They can teach you techniques to retrain your vagina to respond normally to penetration.

The specialist may also offer you:

Your treatment plan will be based on your needs. You will be encouraged to take full control of your self-help treatment and to go at your own pace. If you have a partner, they can also be involved in your treatment.

Sex therapy is available privately. Unfortunately, in many parts of the UK, it is no longer available through the NHS.

Vaginal trainers

Vaginal trainers can be used to help you relax the muscles in your vagina. These are a set of four smooth, penis-shaped cones in different sizes, which can be used in the privacy of your own home.

The smallest cone 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 is important to go at your own pace and it doesn't matter how long it takes, whether it is days or months.

When you are able to tolerate the larger cones without any pain or feeling anxious, you and your partner may want to try having sex.

It is important to note that in cases of vaginismus, vaginal cones are not used to "stretch" a vagina that is "too narrow". Women with vaginismus have normal sized vaginas. The cones are simply a method of teaching the vagina to accept penetration without automatically contracting the pelvic floor muscles.

If you find you are unable to use vaginal trainers, you could try using your fingers.

Relaxation and touching

If the vaginal trainer method does not work for you, relaxation and exploration exercises may help. 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 practise 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.

Again, it is important to take things slowly and gently and, when you are ready for intercourse, make sure you are fully aroused before attempting penetration.

Pelvic floor exercises

A physiotherapist may be able to teach you some pelvic floor exercises that will help relieve your symptoms of vaginismus, such as squeezing and releasing your pelvic floor muscles. These exercises are recommended while using vaginal trainers.

Biofeedback is a way of monitoring how well you are doing the pelvic floor exercises by giving you feedback as you do them. A small probe is inserted into your vagina. It senses when you squeeze your muscles and sends the information to a computer screen.

However, biofeedback is not available at all centres that treat vaginismus, and some practitioners consider this approach not very useful.

Sensate focus

If you are in a relationship, you could try sensate focus. This is a type of sex therapy that you and your partner complete together. It starts with you both agreeing not to have sex for a number of weeks or months. During this time, you can still touch each other, but not in the genital area (or a woman's breasts).

Set aside a time when it is just the two of you. Massage, touch or stroke each other, with or without clothes on. Explore your bodies, knowing that you will not have sex.

After the agreed period of time has passed, you can begin touching each other's genital areas. You may want to spend several weeks gradually increasing the amount of time spent touching the genital areas. You can also start to use your mouth to touch your partner – for example, licking or kissing them. This can build up to include penetrative sex.

You can find out more about sensate focus from the College of Sexual and Relationship Therapists (COSRT).

Surgery

Very few cases of vaginismus require surgery as a treatment option. However, it may be useful if another condition that is suitable for surgery is causing pain during sex and is contributing to your vaginismus.

Endometriosis

Endometriosis is a possible reason for surgery, although it usually causes pain in the pelvis during sex.

Endometriosis is a condition that causes small pieces of your womb lining to grow outside your womb. Surgery can be used to remove or destroy these areas of tissue.

Read more about treating endometriosis.

Enlarging the vagina

Surgery is sometimes used to enlarge the vagina. This may be necessary if, for example, previous surgery has left scar tissue that either restricts or blocks your vagina.

This can occur if it was necessary to make a cut in the area of skin between your anus and vagina during childbirth (episiotomy).  

A small operation called a Fenton's procedure can be carried out to remove the scar tissue. It involves neatly cutting out the scar tissue and sewing together the clean-cut edges using small, dissolvable stitches. The operation can either be carried out under a local anaesthetic or a general anaesthetic.

Page last reviewed: 16/01/2013

Next review due: 16/01/2015

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The 1 comments posted are personal views. Any information they give has not been checked and may not be accurate.

because it works said on 10 May 2013

I have been using a Vaginal Acceptance Trainer and the results I got were fantastic. I was nervous but got a grip on the problem and now I can say hand on heart the problem has gone away. Sex has become easier with every attempt and I have had a smear which I was able to go to thanks to this treatment. I dithered for ages but took the plunge and opted for a Vaginal Acceptance Trainer and it sorted me out and the years of misery are behind me, I hope this helps other ladies never to give up hope because sharing information is the only way to beat this blight on women.

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