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Understanding & Overcoming Secondary Vaginismus

Understanding and Overcoming Secondary Vaginismus

Vaginismus is a condition that affects many women and can have a significant impact on their sexual health and well-being. 

Primary vaginismus refers to the condition always present when attempting vaginal penetration, while secondary vaginismus refers to its onset subsequent to being able to have pain-free penetrations in the past. 

This blog aims at breaking the silence and providing a comprehensive understanding of secondary vaginismus, its causes, symptoms, and – most importantly – its treatment options. By the end of this post, readers will have a better understanding of this condition and feel empowered to take control of their genital & sexual health.

What is Secondary Vaginismus?

Secondary vaginismus can develop for many reasons including surgery, childbirth, painful infection (urinary, vaginal, etc.), extreme vaginal dryness, menopause, cancer treatment, emotional distress, relationship issues, Sjogren’s Syndrome, and – although less common – sexual trauma. 

Despite it being so common, secondary vaginismus remains a difficult and embarrassing subject to talk about, with women often believing that they are the ‘only one’ suffering from their vagina that suddenly is failing them. 

If this speaks to you, please understand that you are not alone and that effective treatment options are available and that the vagina can come back to life in a good way!  Read on.

Our Experience with Secondary Vaginismus

We see and treat women with secondary vaginismus on a regular basis, each being amazed to learn that it is such a common condition despite the ignorance and hush-hush attitude surrounding it.  Read our in-depth information here.

One of our patients, a menopausal woman in her early 60s, had given up on sexual intimacy several years prior because of the pain she experienced during intercourse. After conducting an internet search for solutions, she found her way to our clinic. During her treatment, she made great progress and could resume sexual activity without pain.

The last step in her treatment involved simulating a gynecological exam, which also became a source of pain and discomfort for her. However, it was smooth and easy this time, bringing back memories of the “good old days” before menopause.

Another typical patient lost the ability to use her vagina after being diagnosed with breast cancer and being put on oral chemo medication, which sent her into instant menopause.  Her vagina became dry, less elastic, more susceptible to chafing irritation, and painful to penetration (intercourse and vaginal exam). How did this woman cope? She gave up any hope of ever using her vagina again.  So sad, isn’t it?

Another case of secondary vaginismus: he ‘gave’ her oral herpes on her genitals during sex with resulting severe penetrative pain, which triggered her underlying anxiety, sending her into a spiral of body & mind secondary vaginismus. 

And yet another case, a new mother after vaginal delivery with suture repair, who became fearful of rupturing the episiotomy and of injuring her vagina by resuming intercourse after the immediate postpartum recovery period.   

And these are just four examples of how secondary vaginismus comes to be, and why it is common…

Prevalence of Secondary Vaginismus

Secondary vaginismus is a common condition because of its many potential causes, with the most common ones being genital anxiety, menopause, or cancer treatment. 

It’s important to note that secondary vaginismus can occur at any age and profoundly impact a woman’s sexual health and well-being. The condition can cause significant distress and affect a woman’s self-esteem, relationships, and overall quality of life.

Despite its prevalence, treatment of secondary vaginismus remains poorly understood, and the woman’s suffering being often dismissed. This highlights the need for increased awareness about the prevalence of this condition, as well as improved access to effective treatment options.

Causes of Secondary Vaginismus

As was described above, secondary vaginismus has many causes, may they be mechanical, medical, hormonal, environmental, psychological, or relationship-dependent.   While the exact cause will vary from woman to woman, several common factors can play a role: a vagina that lost its ability to have pain-free use and/or an underlying anxiety that settled in the vagina.

The good news is that, in most cases, secondary vaginismus is reversible with the right, personalized treatment, and that there is no reason for the suffering woman to give up on her genital and sexual life.

Symptoms of Secondary Vaginismus

The symptoms of secondary vaginismus will depend on the cause but there are several universal common denominators: 

Pain during Intercourse

One of the most common symptoms of secondary vaginismus is pain during sexual intercourse. This is due to vaginal dryness, vaginal inelasticity, painful surgical scar, or muscle spasms in the vaginal entrance. The pain can range from mild discomfort to severe and can make sexual activity a source of fear and anxiety.

Difficulty with Vaginal Penetration

In addition to intercourse, women may struggle with the other vaginal penetrations, i.e. tampons, speculum for gynecologic examination, and probe used for vaginal sonogram.  The severity will range from mild to impossible, depending on the narrowness and pliability of the vagina, and the presence of associated anxiety.

Emotional distress / emotional resignation

Who wants to feel pain?  Who wants to associate sexual fun with pain and negativity? Why feel that ‘my vagina is not mine?’  What do I tell the partner? How do I overcome the fear of using my vagina?  What is wrong with me? Should I just give up and resign to living like this?  These are just a few of the common scenarios women with secondary vaginismus struggle with.  Far from feeling adequate and self-confident, would you say?

Diagnosis and Treatment of Secondary Vaginismus

Diagnosing secondary vaginismus involves a comprehensive evaluation by a qualified healthcare provider. This may include a physical exam, medical history, and a discussion of symptoms and concerns. In some cases, additional testing may be necessary to determine the underlying cause of the condition.

Once a diagnosis has been made, the next step is to develop an effective treatment plan. There are several treatment options available for secondary vaginismus, including:

Medical intervention

This will aim at addressing medical causes for vaginismus, including pharmacology, hormonal/estrogen replacement, antibiotics, topical medicinal applications, surgical intervention, etc.

Therapeutic Interventions

Therapeutic approaches when applicable will include pelvic floor rehabilitation, mental health counseling and therapy, pharmacology for anxiety management, vaginal lubricants, vaginal dilators for restoring elasticity and pliability, lifestyle modifications, etc.

Sexual Intervention

This will include, when applicable, sexual counseling, sex therapy, sexual education, different sexual positions and their benefits, aids for vaginal comfort (lubrication, etc.), and whatever else the case may call for. 

Treating Secondary Vaginismus at Women’s Therapy Center

We understand the impact that secondary vaginismus can have on women who suffer with secondary vaginismus. That is why we are committed to providing treatment options to help women overcome secondary vaginismus and reclaim their sexual health and well-being.

We have different treatment travel plans to consider – watch this short video.

Comprehensive and Customized Secondary Vaginismus Treatment

Our approach to treating secondary vaginismus is comprehensive and customized, considering each woman’s needs and concerns. We work with you to develop a treatment plan that addresses the condition’s underlying causes and provides relief from the physical and emotional symptoms.

Education and Support for Secondary Vaginismus

At the Women’s Therapy Center, we do not stop at the ‘symptoms’ category but rather expand our intervention to also offer a range of support services in order to address the woman as a ‘whole.’ 

Coping with Secondary Vaginismus

Living with this condition can be difficult, and it is important to remember that effective treatment options are available and that there are strategies for coping with the symptoms and improving quality of life.


Education and awareness are among the most important strategies for coping with secondary vaginismus. By learning more about the condition and available treatment options, women can address the cause and reclaim their emotional and sexual health.

Communicating with Your Partner about Secondary Vaginismus

Secondary vaginismus can impact a woman’s sexual health and intimate relationships, making effective communication with her partner crucial. To improve your relationship and manage the condition, it is important to:

  • Be honest and open about your feelings and concerns
  • Create a safe and supportive environment for communication
  • Focus on solutions and alternative forms of intimacy
  • Nobody is to be blamed as the woman did not ask for this!

Seeking Support from Friends and Family

Having a strong support system is always helpful for managing breakdowns in life.  Although secondary vaginismus may seem too private to discuss, trust that women will always be able to relate to your struggle whether they do too, and you may be surprised to find out that they also have been wrestling with the same!  Teaming up is of great value.   

Talking to a Therapist

Therapy and counseling can also be effective in helping women cope with secondary vaginismus. These approaches can help women address the emotional and psychological factors that contribute to the condition and find relief from the physical and emotional symptoms.

Engaging in Self-Care and Lifestyle Management

Engaging in self-care is vital to keep yourself in the most positive shape possible.  Add to it lifestyle improvements and your spirit may elevate greatly despite the secondary vaginismus, giving you emotional strength to tackle necessary treatment and to find a cure.  Actually, these are important components that should be included in everyone’s life at all times:

  • Maintain exercise and physical activity
  • Practice meditation and mindfulness
  • Try aromatherapy for reducing stress
  • Massage therapy;
  • Relaxation techniques

In Summary

Secondary vaginismus happens.  You did not ask for it but don’t feel doomed and condemned.  Seek advice and solutions.  Speak up about it without embarrassment.  It is not just about sex but rather about life.

Contact Us to schedule an appointment.

About The Author

vaginismus specialist Dr. Ditza Katz team member Women's Therapy Center

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