What is Vaginismus? (And what you can do about it)
Vaginismus is when the muscles around the vaginal opening involuntarily tighten, making penetration painful, difficult, or impossible. This can happen during sex, when using tampons, or during pelvic exams.
If this sounds familiar, you're not alone—and you're not broken.
What causes it?
Vaginismus isn't about willpower or "relaxing more." It's an automatic protective response from your nervous system. Your body is trying to protect you from pain or perceived danger, even when your mind knows you're safe.
It can develop for many reasons:
Previous painful experiences (including first-time sex or medical procedures)
Fear or anxiety about penetration
Past sexual trauma or abuse
Cultural or religious messaging about sex being shameful or wrong
Medical conditions that cause pain (like infections or endometriosis)
Sometimes, there's no obvious reason at all
The important thing to know is that vaginismus is a physical response to something your nervous system has learned—and what's been learned can be unlearned.
It's more common than you think
Research shows that around 20% of women experience painful sex at some point in their lives, and vaginismus affects approximately 6% of women globally. You're far from alone in this.
Many women live with it for years before seeking help because they feel ashamed or think "something is wrong with them." But vaginismus is a treatable condition, not a personal failing.
When to see a GP vs. a pelvic floor physio vs. a therapist
See your GP first if you're experiencing pain during sex or difficulty with penetration. They can rule out infections, skin conditions, or other medical issues that might be causing pain. Your GP can also refer you to specialists.
See a pelvic floor physiotherapist for the physical side of vaginismus. They can teach you exercises to help your pelvic floor muscles relax, use dilators if appropriate, and address any physical tension or pain. (See our Local Services page for pelvic floor physios in Armidale.)
See a psychotherapist or sex therapist (like me!) to address the nervous system side of things. We work with your body's protective responses, help rewire patterns of fear or pain, and support you in building safety and capacity for pleasure. Therapy is especially helpful when trauma, anxiety, or shame are part of the picture.
Often, the best approach is a combination of pelvic floor physio and psychotherapy working together.
What therapy can help with
In therapy, we don't just talk about vaginismus—we work with your body and nervous system to:
Build a sense of safety and control
Rewire automatic pain or fear responses
Address shame, anxiety, or past trauma
Develop body awareness and connection
Create new pathways to pleasure and intimacy
The work is slow, gentle, and completely at your pace. You're always in control.
The bottom line
Vaginismus is real, it's treatable, and you don't have to figure it out alone. Whether you start with your GP, a pelvic floor physio, or a therapist, taking the first step is what matters.
Your body isn't broken—it's trying to protect you. And with the right support, you can help it feel safe again.