Vaginismus is a condition in which involuntary muscle spasm interferes with vaginal intercourse or other penetration of the vagina. This often results in pain with attempts at sex. Often, it begins when vaginal intercourse is first attempted.The formal diagnostic criteria specifically requires interference during vaginal intercourse and a desire for intercourse. However, the term vaginismus is sometimes used more broadly to refer to any muscle spasms occurring during the insertion of some or all types of objects into the vagina, sexually motivated or otherwise, including the usage of speculums and tampons.The underlying cause is generally a fear that penetration will hurt. Risk factors include a history of sexual assault, endometriosis, vaginitis, or a prior episiotomy. Diagnosis is based on the symptoms and examination. It requires there to be no anatomical or physical problems and a desire for penetration on the part of the woman.Treatment may include behavior therapy such as graduated exposure therapy and gradual vaginal dilatation. Surgery is not generally indicated. Botulinum toxin (botox), a muscle spasm treatment, is being studied. Estimates of how common the condition is vary. One textbook estimates that 0.5% of women are affected. Outcomes are generally good with treatment. Signs and symptoms
Severity and pain during vaginal penetration varies. Causes
Primary vaginismus
Vaginismus occurs when penetrative sex or other vaginal penetration cannot be experienced without pain. It is commonly discovered among teenage girls and women in their early twenties, as this is when many girls and young women first attempt to use tampons, have penetrative sex, or undergo a Pap smear.
A 2016 textbook estimated about 0.5% of women are affected, while rates in Morocco and Sweden were estimated at 6%.Among those who attend clinics for sexual dysfunction, rates may be as high as 12 to 47%. See also
Hymen
Penis captivus
Vulvodynia

References
Further reading
Crowley T, Richardson D, Goldmeier D (January 2006). "Recommendations for the management of vaginismus: BASHH Special Interest Group for Sexual Dysfunction-free". Int J STD AIDS. 17 (1): 14–8. doi:10.1258/095646206775220586. PMID 16409672. S2CID 14152533.