Vaginismus is when the muscles around the vagina tighten (contract) against your will, causing the vagina to spasm. In some cases, this can be quite painful.

There are several symptoms of vaginismus including:

• involuntary (against your will) spasm of the muscles in the vagina
• fear of pain or real pain
• intense fear of penetration
• loss of sexual desire if penetration is attempted
• pain if penetrated by a tampon, finger or penis.

The vagina muscles go into spasm, usually in response the vagina or vulva being touched before sexual intercourse. It can also happen if penetration of the vagina by the penis (sexual intercourse) is attempted, or during a gynaecological examination. Some women find that they cannot use tampons when they have a period (menstruate) because of vaginismus.

These symptoms are entirely involuntary - the woman can do nothing to stop it.

It is a psychological problem that shows itself in a physical way and is fairly common among women, especially women in their late teens to thirties.

There are many factors that cause vaginismus. Some women have had the condition all their adult lives and may never have had sex because of it. With others, it may be due to other reasons, for example, a difficult childbirth or sexual trauma.

Vaginismus is not rare it affects thousands of women from many different backgrounds, it is poorly understood and rarely discussed with general practitioner's. Many women will experience Vaginismus at some time in their lives, even if they have had a previous sexual history of enjoyable and painless sex.

Primary vaginismus is diagnosed when a woman has never experienced vaginal penetration, and secondary vaginismus is diagnosed when a woman has had penetration without a problem in the past.

Diagnosis is based on the woman’s medical history, the symptoms and a physical examination, if possible. The severity of the symptoms can lead to a general sexual inhibition with avoidance of any sexual touching, and in most severe cases can lead to avoidance of any affectionate touching.

Any physical disorders that may be causing or contributing to vaginismus will need to be treated, for example, an injury or infection.

However, if the cause of the condition is psychological, then counselling for the woman and her partner (if she is in a relationship) is needed.

Treatment will depend on whether the root cause can be identified. If there is an obvious physical cause such as an injury or infection, then this can be treated with appropriate medication.

There are many different causes of vaginismus, although the reason depends on the individual person and it is not always fully understood why the condition happens. Cognitive behavioural treatment programmes for vaginismus comprise of a programme of relaxation with specific exercise for relaxing the muscles around the vagina and a desensitisation of the vagina.

Some cases appear to have a physical cause such as an injury, inflammation of the vagina, pelvis or bladder. It may be because of persistent vaginal dryness or irritation due to spermicides or latex (rubber) in condoms. Even if the original physical cause has disappeared, vaginismus can still continue to happen.

Vaginismus has also been linked to fear or dislike of sex and may be related to difficult or painful sexual intercourse (known as dyspareunia). It can also a side effect of alcohol, medication or drugs.

Other factors may be the fear that the vagina is too small for sexual intercourse. It could also be due to unpleasant sexual experiences at a young age or the first sexual experience.

Treating vaginismus may involve the following sexual education:

• Control of vaginal muscles
• Self exploration of sexual anatomy
• Insertion of a trainer under controlled relaxation
• Sharing of control with a partner
• Exploration of phobia.