I think I have vaginismus: what should I know?

Vaginismus is an automatic tightening of the pelvic-floor muscles when penetration is attempted or anticipated. It may make vaginal sex, tampon use, menstrual cups, or an examination painful or difficult. Some people experience [Pain During Sex](/symptoms/pain-during-sex/) or burning, while others mainly notice blocking, fear, or muscle spasm. The response can begin after pain, infection, injury, childbirth, surgery, trauma, relationship stress, or a previous difficult examination, and sometimes there is no single clear trigger.

A careful clinician can check for skin, vaginal, pelvic-floor, infection, hormonal, or other causes of pain. Your experience is real, and an examination should stop if it becomes too uncomfortable. Vaginismus is not a sign that you are failing or unwilling.

Arrange an appointment with a clinician who is comfortable discussing pelvic pain and sexual health. Explain what types of touch or penetration cause symptoms and what you can tolerate. Do not force penetration or continue through sharp pain. Treatment may combine education, breathing and relaxation, counselling when helpful, and [Pelvic Floor Physiotherapy](/treatments/pelvic-floor-and-rehabilitation/pelvic-floor-physiotherapy/). Some people are offered [Vaginal Dilator Therapy](/treatments/pelvic-floor-and-rehabilitation/vaginal-dilator-therapy/) using gradual, patient-controlled steps; it should never be forced.

Seek prompt assessment for new severe pelvic pain, fever, unusual discharge, sores, bleeding after sex, or suspected pregnancy with pain. Seek urgent care for heavy bleeding, fainting, or rapidly worsening symptoms. Otherwise, make a routine appointment when pain or tightening prevents examinations, tampons, sex, or other activities, especially if it is causing distress. A clinician can look for treatable causes alongside pelvic-floor tightening.

Could infection, skin irritation, pelvic-floor tension, hormonal change, or another condition be contributing?

How can an examination be adapted so I remain in control and comfortable?

Would pelvic-floor physiotherapy, counselling, or gradual dilator therapy suit my symptoms?