When Sex Is Painful: A Vaginismus Deep Dive

Let me paint the scene… The candles are lit. A slow, groovy song is playing on the stereo. Your partner is tenderly kissing your neck, and slowly guiding you to the bed. You lie down, open your legs…  And feel a stabbing pain when you try to have sex. You try again – but every attempt at sex is so painful that you have to stop. You lie there, frustrated and ashamed, and wonder what the hell people are talking about when they say they enjoy penetrative sex. Welcome to vaginismus.

1 in 10 women find sex is painful

Vaginismus is a condition where the vagina contracts in response to contact, pressure or insertion. Vaginismus can make any kind of vaginal penetration, from tampon insertion, pelvic exams, or yes, even sex, painful or impossible. This causes sensations including tightening, tensing, burning, stinging, tearing or aching. For many women, vaginismus feels like they have a barrier at the opening of their vagina, which makes penetration feel impossible.

Like many women’s health conditions, vaginismus often flies under the radar. Many doctors are uneducated about the condition, and many women suffer in silence because they are too embarrassed to seek help. If you are reading this and think you might have vaginismus, welcome to the club. And don’t worry – it is treatable!

The emotional toll

The physical pain caused by vaginismus feels unbearable. But the emotional pain can be just as bad. I have vaginismus, and it makes me feel embarrassed, inadequate, alienated, and dysfunctional. When I watch sex scenes in movies, or talk to my friends about their latest ‘sexcapades’, I don’t relate at all. For them, sex is pleasure. Love. Intimacy. Fun. For me, sex is painful and anxiety inducing. I used to avoid sex altogether before I started treatment for vaginismus because of the physical and emotional pain it causes. This avoidance is harmful not just on a personal level – it can also be detrimental to relationships.

The emotional toll of vaginismus can have a major impact on overall mental wellbeing and confidence. The continuous cycle of anticipation, pain, and avoidance can lead to feelings of frustration and isolation. Many women find it embarrassing to talk about, which only increases the sense of loneliness. Over time, vaginismus can have a lasting negative impact on self-esteem, confidence, happiness, relationships and intimacy.

Read more: Vaginismus, Sex Toys, And You

What causes vaginismus?

In 90% of cases, vaginismus is a psychological condition. There are all sorts of reasons sex is painful, including general anxiety, stress, sexual trauma, fear of pain or fear of pregnancy. There can also be physical causes, including chronic pain, physical trauma, or endometriosis. Vaginismus is classified into two types: primary and secondary.

Primary vs secondary vaginismus

Women with primary vaginismus find any sort of penetration – including sex – too painful. Primary vaginismus commonly results from young women having troublesome or painful first experiences with tampons. These experiences can be extremely uncomfortable, and cause a general fear and avoidance of penetration.

Secondary vaginismus, on the other hand, occurs in women who have previously been able to have successful, pain-free penetration – but who later struggle with it due to factors like emotional or physical trauma, surgery, chronic infection or menopause.

Thankfully, both primary and secondary vaginismus can be treated with gentle, non-surgical and self-directed methods.

Sex is painful: what are the treatments?

Although there is no hard and fast ‘cure’ for vaginismus, there are a number of treatments available including education, counselling and exercises that help to relax the vaginal muscles. The first step should be having a chat with your GP, so that you can find out which treatment options will be most suitable for you, and receive the support you need. Having said that, here are some common treatments for vaginismus so you can get an idea of what may help.

Vaginal dilators & vibrators

Vaginal dilators are the most common treatment for vaginismus. Dilators come in progressive sizes, allowing a person to start with the smallest and most comfortable size, and gradually move up to larger sizes as they become more comfortable. The goal is to train the vaginal muscles to relax and stretch, which makes penetration less painful. Most dilators come with instructions, which makes the whole process a lot less intimidating.

Vibrators can also be therapeutic for those with vaginismus. The gentle vibrations can help relax the pelvic muscles, decrease spasms and increase vaginal lubrication, making penetrative sex less painful. They can also provide a means of self-exploration and desensitisation, and make the vagina more accustomed to sensation and touch. Lay on vibrators like the Wild Secrets Desire or a gentle clitoral suction toy like the Womanizer Premium 2 can be great for offering non-penetrative pleasure. Yes, you can still have great sex without it being painful, even with vaginismus.

Pelvic floor therapy

Pelvic floor therapy helps to strengthen the pelvic floor muscles – the muscles that support the bladder, uterus, and rectum. When these muscles are weak, they can cause several problems, including incontinence, pain during sex, and difficulty achieving orgasm. Pelvic floor therapy can strengthen these muscles and relax the muscles that cause spasms, which will make sex less painful and more enjoyable.

Relaxation and mindfulness

Stress, anxiety, and anticipation of sex being painful can exacerbate the symptoms of vaginismus. Studies have shown that relaxation techniques, such as deep breathing, progressive muscle relaxation, and meditation, can help in calming the body and mind when used in conjunction with the physical therapies above.  Mindfulness practices can assist individuals in staying present, recognising bodily sensations without judgment, and reducing the fear response that may trigger muscle contractions. Some relaxation techniques that can be helpful for vaginismus include deep breathing or ‘box breathing’, visualisation, progressive muscle relaxation and self-massage.

Sex therapy

Sex therapy and counselling can help women to explore the psychological and emotional factors that may be contributing to their vaginismus, such as anxiety, stress, trauma, stress or relationship issues. It can be done alone or as a couple, and aims to help you rediscover of passion, relaxation and pleasure.

Combining several of these treatments can offer a holistic approach to managing and overcoming vaginismus, addressing both the physical and emotional aspects of the condition.

Vaginismus isn’t the end of your sex life

Clinical trials have found that it is possible for people with vaginismus to overcome their condition and go on to have a healthy and enjoyable sex life. The treatments we mentioned above have shown remarkable benefits for women with the condition. Not ready to start treatment yet? That’s okay! Having vaginismus doesn’t mean saying goodbye to intimacy. There are plenty of ways to get intimate without penetration – whether alone or with someone else. Options include masturbation, oral sex, touching, kissing, massage and using sex toys like vibrators.

Healing the mental and physical impacts of vaginismus and sex being painful takes time, but it is possible.

Resources for vaginimus

If you find that sex is painful, have vaginismus, or think you might have it, here are some resources that can help. Before you jump into self diagnosis, please be aware that this is one person’s experience and research. Speak to a medical professional and get a personalised treatment plan if this is journey you think you need to go on.

• So speak to your GP. They can provide an initial assessment, refer you to specialists, and provide guidance on your treatment.
• Jean Hailes is a not-for-profit organisation dedicated to improving women’s health. They provide valuable information and resources on a variety of topics, including vaginismus.
• Sexual Health Australia offers counseling and therapy services for various sexual health issues.
• Online Forums and Support Groups: There are several online platforms where women with vaginismus share their experiences, support each other, and offer advice. These forums can be a great way to connect with others who are going through similar experiences to you. One I’ve found useful personally is the vaginismus subreddit.
• Relationships Australia: If vaginismus is affecting your relationship, this organisation offers affordable counselling services to couples and individuals.