Vaginismus is defined as the recurrent or persistent involuntary contraction of the perineal muscles surrounding the outer third of the vagina -see diagram-, when vaginal penetration with penis, finger, tampon, or speculum is attempted. In some females, even the anticipation of vaginal insertion may result in muscle spasm. The contraction may range from mild, inducing some tightness and discomfort, to severe, preventing penetration and coitus (introital dyspareunia).

Sexual responses (e.g., desire, pleasure, orgasmic capacity) may not be impaired unless penetration is attempted or anticipated.

The disorder is more often found in younger than in older females, in females with negative attitudes toward sex, and in females who have a history of chronic vulvar pain (vulvodynia), or sexual abuse.

Lifelong or primary Vaginismus usually has an abrupt onset, first manifest during initial attempts at sexual penetration by a partner or during the first gynecological examination. Once the disorder is established, the course is usually chronic unless ameliorated by treatment. Acquired or secondary Vaginismus also may occur suddenly in response to a sexual trauma or a general medical condition, e.g. vulvar vestibulitis syndrome.

Since Vaginismus may remain as a residual problem after resolution of the associated medical condition, the therapy of vaginismus is an integral part of the medical care for vulvodynia. It consists of desensitization exercises, that include Kegel exercises, vaginal relaxation and physiotherapy, as well as gradual dilator therapy.