A Look Into Vaginismus

Vaginismus is a pelvic health condition that affects an estimated 5–17% of women but is often underdiagnosed and undertreated worldwide. It occurs when attempts at vaginal penetration—such as inserting a tampon, having intercourse, using a dilator, or undergoing a gynecological exam—cause significant pain or are impossible. Understandably, this condition can deeply affect an individual’s physical comfort, emotional well-being, and confidence.

In this article, we’ll explore what vaginismus is, common causes and symptoms, and how pelvic floor physiotherapy can play a key role in successful treatment.

What Is Vaginismus?

Vaginismus is characterized by the involuntary tightening or spasm of the pelvic floor muscles surrounding the vaginal opening. This automatic muscle contraction can make vaginal penetration painful or impossible. For many people, this reaction is a protective reflex—the body’s way of guarding against real or anticipated pain.

What Causes Vaginismus?

The exact cause can vary from person to person. Psychological factors such as anxiety, fear of pain, negative sexual experiences, or a history of trauma or abuse can contribute. Physical factors may also play a role, including recurrent infections, pelvic surgery, scar tissue, hormonal changes, or vaginal dryness. Often, vaginismus involves a combination of both physical and emotional triggers.

Common Symptoms

Many people with vaginismus experience one or more of the following:

• Pain or tightness with attempted penetration (e.g., during intercourse, tampon use, or medical exams)

• Burning or tearing sensations with insertion attempts

• Fear, anxiety, or emotional distress related to sexual activity or pelvic exams

How Pelvic Health Physiotherapy Can Help

Pelvic floor physiotherapy is one of the most effective and evidence-based treatments for vaginismus. At Ottawa Pelvic Health, our physiotherapists provide a safe, supportive environment to help you retrain your body, regain control, and reduce pain.

Here’s how we can help:

Comprehensive Assessment

Your physiotherapist will take a detailed medical and psycho-sexual history to understand your symptoms, goals, and comfort levels. If appropriate and with consent, an external and/or internal pelvic floor assessment may be performed to evaluate muscle tone, flexibility, and areas of sensitivity.

Personalized Education

You’ll learn about your pelvic floor anatomy, how the muscles function, and why pain may be occurring. Understanding the why behind your symptoms is an important first step toward empowering your recovery.

Muscle Relaxation and Nervous System Retraining

Because vaginismus often involves protective nervous system responses, therapy focuses on calming these signals. Techniques such as breathing exercises, body awareness, relaxation training, and biofeedback can help you regain control of your pelvic muscles.

Manual Therapy

Gentle, hands-on techniques can release tension and improve flexibility in the pelvic and surrounding muscles, helping reduce sensitivity and pain.

Dilator Therapy

When appropriate, your physiotherapist may guide you through a gradual dilator program to safely and comfortably increase tolerance to vaginal penetration over time.

While vaginismus can be distressing, it is absolutely treatable. With the right care and guidance, recovery is not only possible—it’s expected.

At Ottawa Pelvic Health, we’re here to support you on your journey to healing and greater comfort.

If you have questions or would like to learn more, book a free 15-minute phone consultation with one of our Pelvic Health Physiotherapists today.

1. Pacik, P. T., & Geletta, S. (2017). Vaginismus Treatment: Clinical Trials Follow Up 241 Patients. Sexual medicine, 5(2), e114–e123. https://doi.org/10.1016/j.esxm.2017.02.002