What should you know about overcoming vaginismus?

Vaginismus is an involuntary tightening of muscles around the vaginal opening when penetration is anticipated or attempted. It may affect intercourse, tampon use, examinations or inserting a menstrual product. Pain during sex can have several causes, including infection, dryness, skin conditions, endometriosis or pelvic floor tension, so an assessment should be respectful and proceed only with your consent.

Start with an explanation of the pelvic floor response and a plan that feels manageable. Pelvic floor physiotherapy can address guarding, breathing, relaxation and muscle coordination. Counselling or sex therapy may help with fear, past pain, relationship pressure or trauma. Vaginal dilator therapy uses gradual, self-paced practice with lubrication and relaxation; it should never be forced or used through sharp pain. Treating dryness or another pelvic condition may also be part of care.

Arrange an assessment when penetration is painful, repeatedly impossible, or causing distress. Seek prompt care for new severe pelvic pain, fever, unusual discharge, sores, bleeding after sex or possible pregnancy with pain. Tell the clinician what you can and cannot tolerate so the examination can be adapted.

Ask whether another condition could be contributing, whether pelvic floor physiotherapy is suitable, how to begin gradual work safely, and what to do if an examination or exercise increases pain.