Understanding Vaginismus: Breaking the Silence Around a Painful Reality
When we talk about sexual health, certain topics still remain shrouded in silence—vaginismus is one of them. For many people with vaginas, this condition can turn intimacy, medical exams, or even the act of using a tampon into a source of fear, frustration, and pain.
What Is Vaginismus?
Vaginismus is a condition involving involuntary tightening or spasming of the vaginal muscles when penetration is attempted. This can happen during sex, gynecological exams, or even when inserting a tampon.
Common Symptoms
Pain during sex (often described as burning, stinging, or a feeling of "hitting a wall")
Difficulty inserting tampons or undergoing pelvic exams
Anxiety or fear around vaginal penetration
Muscle spasms or tension in the pelvic area
Avoidance of sexual activity due to fear of pain
Treatment Options
The good news is that vaginismus is treatable, and most people improve significantly with the right care and support. Working with a pelvic health therapist should be a standard of care when it comes to guidance on how to address the symptoms of vaginismus.
Other considerations when approaching the treatment of vaginismus are:
Dilator therapy: Gradually inserting dilators/trainers of increasing size to gently retrain & desensitize the the vaginal muscles
Cognitive-behavioral therapy (CBT): Addressing fears, anxiety, or trauma associated with penetration
Couples therapy or sex therapy: Especially when emotional or relational issues play a role
Education and communication: Understanding how your body works and learning to express your needs and limits.
Healing Takes Time—and Patience
Recovery is not a race. It’s a journey that looks different for everyone. Some people respond quickly to therapy, while others take more time—and that’s okay.
What’s most important is knowing you’re not alone, and that pain doesn’t have to be your “normal.” There is no shame in seeking help, and healing is absolutely possible.
Interested in learning more or working with a pelvic health specialist?
I offer 1 on 1 treatment in Columbus, Ohio
Schedule your free 15min phone consultation!
In health,
Emma Lengerich PT, DPT, OCS, CMTPT, PCES, Birth Doula Foundations PelvicPhysio, LLC Orthopedic & Pelvic Health Physical Therapist & Birth Doula Instagram: @emma_pelvichealth Subscribe to my newsletter: Click Here!
Resources
International Society for the Study of Women’s Sexual Health (ISSWSH)
Pelvic Pain Support Network
The Vaginismus Network (UK)
Books like "When Sex Hurts" by Drs. Andrew Goldstein, Caroline Pukall, and Irwin Goldstein
