Why does vaginismus cause pain during sex?

The tightening can narrow the vaginal opening and increase pressure on sensitive tissues. Anticipating pain may trigger more guarding, creating a cycle in which discomfort reinforces muscle tension. Pain During Sex is a common presentation of Vaginismus. It may happen with a penis, finger, tampon or examination, and it can affect people who have had comfortable penetration before. Other causes of painful sex, such as dryness, infection, skin irritation or deeper pelvic conditions, can occur alongside it or instead of it.

A healthcare professional can assess the pain gently and check for other causes. Treatment may include pelvic-floor physiotherapy, education about the muscles, gradual desensitisation exercises, and counselling when fear, distress or a previous painful experience is part of the cycle. Lubricant can reduce friction, but do not push through pain or attempt penetration without consent and comfort. Progress is usually guided step by step at a pace you can tolerate.

Seek an assessment if pain is persistent, prevents examinations or tampon use, or is accompanied by bleeding, unusual discharge, sores, fever or pelvic pain. Urgent help is needed for sudden severe pain, heavy bleeding or feeling faint. A clinician can help distinguish muscle tightening from conditions needing different care.

Ask what may be contributing to the tightening, whether pelvic-floor physiotherapy is available, and how an examination can be adapted to keep you comfortable. Ask when to pause exercises and how to measure progress without forcing penetration.