What should you know about secondary vaginismus?

The tightening can make penetration painful, difficult, or impossible. It may occur with sex, a tampon, an examination, or another form of vaginal insertion. The pelvic floor muscles can contract automatically in response to pain, irritation, fear, or an earlier distressing experience.

Possible contributors include vaginal dryness, infection, skin conditions, pelvic pain, hormonal changes, childbirth-related injury, surgery, or pain during sex. Finding a contributor does not mean the symptoms are imagined, and more than one factor can be present.

Arrange an assessment that considers the pelvic floor, vaginal tissues, medications, pain, and emotional wellbeing. Do not force penetration through pain. A clinician may suggest treating irritation or dryness, using gradual relaxation exercises, and working with a pelvic floor physiotherapist.

Some people are offered vaginal dilator therapy, using a gradual and controlled approach. Progress should be comfortable and guided; stopping when pain escalates helps prevent the tightening-and-pain cycle from becoming stronger.

Book care for new or persistent pain during sex, bleeding after penetration, unusual discharge, itching, sores, or pain that interferes with examinations or daily life. Seek urgent help for severe pelvic pain, heavy bleeding, fever, fainting, or possible pregnancy with pain or bleeding.

Ask what might have changed, whether an examination can be adapted, which treatments address pain or dryness, and whether pelvic-floor therapy or dilator therapy fits your situation.