Vaginismus (vah-juh-NIZ-mus) is characterized by strong involuntary contractions of the muscles in the outer third of the vagina. These contractions make attempts to insert a penis into the vagina extremely uncomfortable or painful for a woman. The painful contractions of vaginismus are a conditioned, involuntary response, usually preceded by a history of painful intercourse (Van Lankveld et al., 2006). A woman with vaginismus usually experiences the same contracting spasms during a pelvic exam (Weiss, 2001). Even the insertion of a finger into her vagina can cause great discom­fort. It is important for women and their partners to know that intercourse, tampon use, and pelvic exams should not be uncomfortable. If they are uncomfortable, it is essential to investigate the cause of the discomfort.

Although a woman who experiences vaginismus can learn to prevent the contrac­tions, she does not consciously will them to occur. In fact, the deliberate effort to over­come the problem by having intercourse despite the pain can have just the opposite effect, contributing to a vicious cycle that makes the vaginismus worse. Sexual coercion in marriage can contribute to this problem. For example, a study of sexual problems in traditional Islamic cultures found that 58% of women who had been married without their consent had vaginismus (Aziz & Gurgen, 2009).

Some women who experience vaginismus are sexually responsive and orgasmic with manual and oral stimulation, but others are uncomfortable with most sexual activity and do not experience desire and arousal (Borg et al., 2011; Leiblum, 2000). Because many heterosexual couples regard coitus as a highly important component of their sex­ual relationship, vaginismus typically causes great concern, even if the couple is sexually involved in other ways.