DIAGNOSIS + SPECIALISTS
Be Bold + Courageous
Pelvic Floor Specialists
Several specialists with different specialties assist women with vaginismus, from diagnosis to training.
However, medical diagnosis is typically determined by gynecological exam to rule out other possible conditions and to review patient history. As women go through this process, we encourage them to be patient. Receiving a diagnosis can be a challenge for many women because there is no definitive medical test for the determination of vaginismus. It could take numerous visits to several physicians or specialists before a medical diagnosis is obtained.
If this is your experience, be bold, and advocate for yourself.
To assist women in obtaining a reliable diagnosis for their sexual pain, our modifiable script includes helpful tips to
prepare for a physician visit.
Women often suspect they have vaginismus from their symptoms, but getting medical confirmation can be challenging.
Confirming a formal diagnosis of vaginismus may take some planning and perseverance.
No definitive medical test exists for diagnosing vaginismus so it may take a number of visits to several physicians or specialists before a medical diagnosis is obtained.
When physicians are initially unable to find any specific medical problem (a common experience of vaginismus sufferers), no diagnosis or misdiagnosis is a common outcome of initial medical exams.
Women need to strongly advocate for themselves, insisting on a full diagnosis from a knowledgeable professional to rule out any other medical condition and properly confirm the vaginismus diagnosis.
A successful medical diagnosis of vaginismus is typically determined through patient history and description of the problem, gynecological examination and the process of ruling out the possibility of other conditions.
Talking to physicians about sexual problems can be difficult. Embarrassment, shame, and anxiety are often present, making it hard to communicate and obtain appropriate care.
A medical vaginismus diagnosis is helpful in removing any doubts or anxiety related to identifying the condition and enables women to have more confidence in moving toward treatment solutions. Sexual pain disorders like vaginismus are commonly misdiagnosed or left unaddressed.
This is especially true in nations with fewer health care options.
Empower yourself to persevere.
Women need to be very courageous until their concerns are given due attention and medical diagnosis is reached. In some cases and locations, a solid medical diagnosis is not always available or possible. Because of this, we encourage you to continue.
Our mission at vaginismus.com and Hope and Her is to help as many women as possible with this condition.
Both websites detail important information about vaginismus and we invite all those suspecting a possible diagnosis to read through the various site topic areas.
Today, there are many wonderful resources to help women learn about vaginismus and treatment. The self-help book offered through our Hope and Her store, go into great detail about the symptoms, causes, and training protocols for successful vaginismus help.
Pelvic Exam as Part of Vaginismus Diagnosis
One of the most critical aspects of vaginismus diagnosis is simply the thorough elimination of other possible physical or medical conditions that may be causing the symptoms, leaving the near-certain likelihood of vaginismus.
The process of elimination is a critical part of vaginismus diagnosis. The diagnostic process will typically entail giving a medical and sexual history and undergoing a pelvic or gynecological exam.
The physician will discuss the location and occurrence of pain to help render an accurate vaginismus diagnosis. They may request some other tests to help rule out any other problems besides vaginismus.
Note that some women feel more comfortable expressing themselves and being examined by female health care specialists. Where this is an issue, we encourage women to seek a referral with a female specialist. Taking a proactive, systematic approach will help a person get better care and treatment outcomes.
Burning, tightness, and difficult penetration symptoms may not be at all noticeable during the pelvic exam. For some women, these symptoms occur only during intercourse attempts.
For this reason, the diagnosis must involve serious consideration of the woman’s concerns which might be stated vaguely as “I’m having difficulty with sex.”
Sometimes, busy health care professionals will fail to recognize the signs of vaginismus and give standard (but unhelpful) advice to just “use more lubricant,” “try to relax more,” or “drink some wine.” This may be due to a lack of familiarity with vaginismus or reliance on outdated literature on the condition.
Due to vaginal muscle tightness, some women with vaginismus find gynecological exams to be extremely painful and are unable to tolerate them. If a woman suspects she may have difficulty completing an exam, she should communicate this to her physician.
Instead of recognizing the vaginismus condition, a physician may falsely believe a woman's vagina is too small, when/if she is unable to complete a pelvic exam.
There are adjustments (e.g. body positioning, size of speculum used, and nurse support) that can be made to contribute to a more positive experience.
When there is constant vaginal tightness for the duration of the pelvic exam, it may appear to the physician as though there is an unusually small vagina or a hymen abnormality problem.
A doctor’s false belief that the vagina is too small, combined with the patient’s urgent complaint that she cannot have penetrative sex with her spouse or that sex really hurts, may further lead to the false assumption that the vagina requires corrective surgery to enlarge the opening and allow entry.
Though there may be rare exceptions, women with vaginismus typically have completely normal genitalia.
The constriction of the vagina is due solely to the tight involuntary spasm of the pelvic floor muscles. Unfortunately, some physicians continue to press forward with the pelvic exam causing great discomfort and pain for the woman. This traumatic experience in itself can contribute to the vaginismus condition.
With vaginismus, the simple approach of a physician’s hand may have the effect of tightening the pelvic floor muscles and making the vaginal entrance seem very small and tight. Note that not all women with vaginismus will experience tightness during a medical exam (tightness may only occur during sex attempts).
The vaginal muscles tighten, closing the entrance to the vagina.
Figure showing constriction during a pelvic exam
There are many dangers in being given an improper diagnosis from an uninformed professional. Unnecessary, invasive and potentially harmful surgeries and medications have been suggested for women with vaginismus who have not been properly diagnosed. Misdiagnosis and the promotion of invasive or unhelpful surgeries are sometimes the unfortunate results of all this confusion.
There is no surgery to cure vaginismus. It is very important to seek a second opinion if surgery to "widen" the vaginal opening has been recommended.
Surgery does not normally resolve the penetration problem, but instead may further complicate the problem.
Unnecessary, invasive, and potentially harmful surgeries and medications have been suggested for women with vaginismus who have not been properly diagnosed.
Vaginismus is a highly treatable condition that does not require any invasive procedures. Many women seeking diagnosis are often simply left undiagnosed and turned away by physicians who fail to find anything physically wrong and feel there is nothing more they can do. They may not consider a diagnosis of vaginismus due to simple lack of awareness.