[13] Despite being fairly common, there is low social awareness of vaginismus and women have difficulty finding support, even through the healthcare system.

In fourth-degree (also known as grade 4) vaginismus, the severest form, the person elevates the buttocks, retreats, and tightly closes the thighs to avoid examination.

Pacik expanded Lamont's classification to include a fifth degree, in which the person experiences a visceral reaction such as sweating, hyperventilation, palpitations, trembling, shaking, nausea, vomiting, losing consciousness, wanting to jump off the table, or attacking the doctor.

Spasm of the entry muscle accounts for the common complaint that people often report when trying to have intercourse: "It's like hitting a brick wall".

[11] The diagnosis of vaginismus, as well as other diagnoses of female sexual dysfunction, can be made when "symptoms are sufficient to result in personal distress.

"[23] The DSM-IV-TR defines vaginismus as "recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that interferes with sexual intercourse, causing marked distress or interpersonal difficulty".

[25] Often, when faced with a person experiencing painful intercourse, a gynecologist will recommend reverse Kegel exercises and provide lubricants.

Achieving sufficient arousal during foreplay is crucial for the release of lubrication, which can ease sexual penetration and pain-free intercourse.

[30] Many people find vaginal trainers like dilators helpful, but some often need more information on how to use them than is provided, or also seek out lubricant, topical anaesthetic or escitalopram,[14] a medicine commonly used to treat depression and anxiety.

[33] Botulinum toxin A (Botox) has been considered as a treatment option, with the idea of temporarily reducing the hypertonicity of the pelvic floor muscles.

No random controlled trials have been done with this treatment, but experimental studies with small samples have found it effective, with sustained positive results through 10 months.

[2][37] The term vaginismus was developed by James Marion Sims in 1866 to describe the “hymeneal hyperaethesia with a spasmodic contraction of the sphincter vaginae” that, under examination, “will produce such agony as to cause the patient to shriek out, complaining at the same time that the pain is that of thrusting a sharp knife into the sensitive part.”[38] At that time, the condition was understood to be biological in origin and medically treatable.

[39] The Netflix miniseries Unorthodox depicted a young woman suffering from extreme pain during intercourse, which she was told was due to vaginismus.

The comedy feature film Lady Parts's main character struggles with painful sex and later is diagnosed with vaginismus.