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What is vaginismus?

Vaginismus is an uncomfortable disorder in which the muscles in the vagina involuntarily squeeze or spasm when something is entering it. This can happen when using a tampon or attempting to have intercourse. This often inhibits women from enjoying intimacy. Patients usually have muscles that are tight as a baseline but then drastically contract when entry is attempted.

Our approach

Our professionals understand that vaginismus is a complex, personal disorder. You can feel comfortable knowing that treating vaginismus is one our specialties. In fact, Northwell Health is one of only two centers in the nation trained in the Pacik method to perform Botox injection of the pelvic floor and vaginal muscles to treat vaginismus. These injections help to lessen the amount of muscle spasms.

You can rely on the knowledge of our specialists and multidisciplinary team to care for every facet of your condition from beginning to end. That means personal one-on-one care with the physician, muscle training and sexual counseling with trained practitioners, and for some connecting you with our physical therapists to give you the comprehensive and personalized care you deserve.


While there is no direct cause of vaginismus, some related factors include:

Non-physical causes

  • Fear of intercourse
  • Fear of pain with penetration
  • General anxiety
  • Childhood experiences
  • Strict upbringing related to sexual activity
  • Abuse/emotional anxiety
  • Distrust
  • Stress

Physical causes

  • Conditions such as endometriosis and pelvic inflammatory disease
  • Pelvic surgery
  • Any type of pelvic trauma
  • Hormonal imbalance
  • Childbirth injury
  • Menopause


Symptoms of vaginismus include:

  • Burning or stinging with tightness during sex
  • Difficulty inserting tampons
  • Pain during a pelvic exam
  • Inability to allow penetration
  • Pain with penetration
  • Sensation of a “wall” preventing penetration

How is it diagnosed?

Your doctor will diagnose vaginismus by evaluating your symptoms, asking about your medical history and performing a physical exam.

Treatment options

Vaginismus is considered to be one of the most treatable sexual disorders. Effective treatment approaches include:

  • Vaginal dilation under anesthesia with Botox injection of the pelvic floor and vagina—This procedure involves gentle sedation and Botox injections, which are used to relax the vaginal muscles. The injections are used in conjunction with a dilator, which helps stretch the muscles. Your physician will also check for any dermatologic causes of discomfort at the entrance of the vagina 
  • Outpatient dilator and pelvic floor relaxation training with a physician’s assistant, nurse practitioner or physical therapist
  • Medication to assist with muscle relaxation
  • Life management coaching to help with stress, tension or emotional issues that may worsen vaginismus
  • Treating any cause of pain which is causing or worsening vaginal spasm
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