Blocked intercourse Women who have vaginismus can't have penetrative sex. But there's no need to put up with this upsetting condition. Psychosexual therapist Paula Hall looks at how it's caused and how it can be treated.

In this article

What is vaginismus? What causes vaginismus?

Unhelpful messages about sex Previous traumatic experiences

Relationship problems Getting help

Vaginismus is a psychological condition that manifests itself in a powerful physical response. Whenever there's an attempt to penetrate the vagina the muscles surrounding the entrance go into involuntary spasm.

Some women may be easily aroused and enjoy regular orgasms - but for some reason, intercourse isn't possible. Others, however, may have little sexual interest and a lot of fears and anxieties about penetration.

Some women will have had the condition all their adult lives, for others it may have occurred after a trauma or in a particular relationship. Either way, vaginismus can have a devastating effect on a woman's quality of life. Not only do they find it more difficult to enjoy love-making, but the inability to be penetrated makes the decision to start a family very difficult.

There are many, many causes. Though none are physical, if you've suffered painful intercourse in the past then vaginismus may be an unconscious response to avoid more pain.

Broadly speaking, the common psychological causes can be split into three categories:

1. unhelpful messages about sex
2. a previous traumatic experience
3. relationship problems

Throughout our childhood we all hear mixed messages about sex.

• Some women are brought up believing sex is a bad and dangerous thing.
• You may have been told not to let anyone touch that area of your body, or warned that you'll get pregnant if anyone does.
• There may have been very powerful cultural or religious taboos that left you with feelings of guilt or shame whenever you felt any sexual desire.
• Puberty may have been associated with feeling dirty or embarrassed.
• If there was inadequate sex education, women can grow up feeling that it's physically impossible to be penetrated.
• You may remember being told that sex is painful.

If, at any stage in your life, you've experienced a traumatic incident associated with your sexuality or your genital area, you may have developed vaginismus as a protective response to further hurt.

That experience may have been a particularly clumsy and painful encounter with a previous partner. It may even have been a clumsy and painful encounter with a GP or nurse attempting a routine internal examination.

For some, vaginismus comes in the aftermath of a rape or sexual abuse. You can phone Rape Crisis on 0115 900 3560 for help and advice if you have been raped or sexually assaulted recently or in the past.

There may be unresolved anxieties between you and your partner that may be causing or at least contributing to your vaginismus. If you're unhappy about something in your relationship, talk it through and try to resolve the issue.

The good news is that vaginismus is a treatable condition once appropriate help has been found.

Start by talking to your GP. You may find that the support and guidance of a psychosexual therapist could help you understand what's causing the problem and how best to tackle it.

There are also a number of ways you could try to help yourself.

Self-help techniques

For ways to put these tips into action, see the section on practical exercises .

• Relax. This is the most important thing you can do. Have a relaxing bath, using deep-breathing techniques or buy a relaxation tape from your local health shop.
• Get to know your own body better.
• Exercise your vaginal muscles. This will help you to feel in better control of your response.
• Enjoy being sensual before you're sexual. Take your time focusing on the pleasurable sensations of touch and make sure you're fully sexually aroused before attempting penetration.
• Desensitise. When you're feeling fully relaxed, take some time to explore penetrating your vagina on your own. You could begin with something like a cotton bud or the tip of your finger. As you grow in confidence, move up to your whole finger and then try with your partner's finger.
• Get a set of vaginal trainers. These are four smooth penis-shaped cones, graduated in size and length. They come with a handle and lubricating jelly to help insertion. Working through the sizes in the privacy of your own home enables you to grow in ability and confidence. Ask your GP or psychosexual therapist for more details.