If Sex Hurts, You May Have Treatable Vaginismus

Vaginismus is the painful involuntary spasming or contracting of the vaginal muscles during sexual intercourse. It can also happen when you try to insert a tampon or have a Pap test.

Because it can interfere with your intimate relationships and quality of life, you should talk to your doctor right away if you experience these symptoms. The good news is, vaginismus can usually be treated successfully.

When Women Experience Vaginismus

While the condition is considered uncommon, I see vaginismus in my sex therapy office fairly often. We don’t know exactly how many women suffer from it. They are often too embarrassed to bring it up with their doctor or therapist.

It is important to know that this condition is never the woman’s fault, and you should never feel ashamed if you have it.

The condition can start when a woman first tries to use a tampon or have intercourse. It can also develop later in life, after a period of sexual activity without a problem. It can happen during every attempt at penetration, or only in some situations, such as while putting in a tampon but not during intercourse.

Vaginismus Causes

Vaginismus is thought to largely be a psychological condition. Contributing factors can include fear or anxiety about sex, prior sexual abuse or trauma, and negative feelings about sexual activities.

Physical conditions can exacerbate the problem, however:

  • Yeast and urinary tract infections can make the pain worse.
  • Sometimes women confuse vaginitis with another condition called vulvar vestibulitis, which involves pain and inflammation around the vulva at the entrance to the vagina.
  • Post-menopausal women can also have pain and discomfort during intercourse due to the lack of estrogen thinning the vaginal walls. This condition is called atrophic vaginitis.


Vaginismus is defined as painful or impossible vaginal penetration during intercourse, tampon insertion or a Pap test. The pain is often described as burning or stinging. See a doctor if you experience this kind of pain.

This condition does not interfere with arousal, and women who have it can still desire sexual pleasure and achieve orgasm. But while the condition persists, it might be a good idea to try sexual activities that don’t involve penetration, such as oral sex, massage or masturbation.


If you seek medical help for suspected vaginismus, your doctor will ask about your symptoms, then do a pelvic exam to rule out other causes for the pain, such as cysts or pelvic inflammatory disease. If there are no physical conditions found, and you only have pain during penetration, you probably have vaginismus.


Vaginismus is usually treated with a combination of Kegel exercises–to strengthen the pelvic floor muscles–and counseling, to address any psychological factors that may be playing a role.

Vaginal dilators are also commonly prescribed. It may intuitively seem like the goal of this therapy is to stretch the vagina, but it is actually to build a comfort level with inserting safe things in your vagina. You can work with the dilators in the privacy of your home. Dilators come in a kit with various sizes, so that a you can start with the smallest one and work your way up to the size of the average penis.

Anesthetic creams can used with the dilators to make insertion more comfortable until you get used to them.

With a combination of physical and psychological treatments, vaginismus can be treated in Charlotte in a fairly short period of time. Don’t wait if you think you may have it. It usually doesn’t go away on its own.