Page last updated May 2020
We asked women what treating vaginismus is like
It was about that time in Heather*’s new relationship when she’d say what she told all her previous partners: “Penetrative sex is not possible”. She knew her body, and felt strongly that this was just the way it was and that there was no way to change it.
When attempting vaginal penetration of any sort — a tampon, a finger, a sex toy, a penis — Heather experienced intense pain as her vagina tightened, preventing anything from going inside. She first experienced this at age 10, when trying to insert a tampon, and decided that there must be something wrong with her. It would take until her mid-twenties for her to be able to have pleasurable penetrative sex with a partner.
Vaginismus is a painful condition where the vagina suddenly tightens as any sort of insertion is attempted, preventing it from happening. It’s completely involuntary and is thought to be caused by a variety of factors, including a fear of vaginal penetration, previous trauma, and a belief that sex is shameful.1
While it is widely considered to be a psychosexual condition, where the mind triggers pain in the body, some physical conditions, including thrush, may also contribute.2 Research on this front is lacking and limited,3 with some disagreement among practitioners on whether vaginismus is primarily mental or physical. Most, however, arrive at the same conclusion: that the condition involves an interplay of both factors and that treatment should address this.
“Each case is completely unique. The approach is broad and multidisciplinary”
Physically, treatment includes use of dilators, with women gradually getting used to the feeling of insertion and moving up to larger sizes when they feel ready.
Lia* was referred to a psychosexual clinic by her GP after being diagnosed with vaginismus, where she was encouraged to use dilators. Treatment was focused mainly on the physical elements of dilation, and after learning that she was able to use them, Lia’s clinician encouraged her to date, so that she could try and have sex.
“I was quite upset when they said that, and I felt like I was never going to be comfortable enough to have sex,” Lia says. Three years on, she still feels the same way.
The clinic ended up closing, and two years later, Lia sought help from a physiotherapist, who coupled physical therapy with breathing exercises to help her feel more comfortable and relax.
While the focus of her treatment has been physical, Lia feels that her journey has mainly been mental. “I’m more confident now and have started to believe I might get through it, I’ve seen more progress and relaxed which helps a lot!” she says.
“I was really hard on myself for a long time, I felt like I wasn’t enough of a woman because I couldn’t have penetrative sex. But then I realised that penetrative sex isn’t everything”
Psychosexual and relationship therapist Sarah Berry believes that physical therapy is effective, but that ultimately, it is within the mind where the foundational work treating vaginismus needs to happen. “If you can do the physical stuff without counselling, that’s great, but that means that you are in a good enough of a mental place for it to work,” she says.
Sarah has been approached by women who have been told by professionals to simply dilate every day, which she says that in itself, is not enough to properly treat the condition:
“This has nothing to do with their mind or their choosing. Dilating every day as a rule isn’t going to do anything unless you are mentally invested. You might just get good at dilating, rather than working towards the goal of feeling something in your vagina. You can be dilating and still not feel like you want to be touched by your partner.”
For Heather, dilation marked important milestones in her journey, but she feels that these successes were the result of the work she did on her mindset and mental strength. “I was really hard on myself for a long time, I felt like I wasn’t enough of a woman because I couldn’t have penetrative sex,” she says. “But then I realised that penetrative sex isn’t everything.”
Hope and belief are the two key ingredients when treating vaginismus, Sarah explains. “It is a very frustrating condition. With vaginismus, you need to create a safe environment for the vagina. The initial steps are small, and people constantly come up to another wall. It’s about really being able to sit with that. People have to want to change.”
“I knew I could put the small vibrator in, and all the way in, and I’d get really proud of myself. And my brain got used to it”
Heather found dilation emotionally draining, but kept going because she thought that it might help. To get used to the feeling of the bullet vibrator, she used it alongside another, bigger vibrator that she used to stimulate her clit. As she became wetter, penetration became easier.
Being able to insert the bullet vibrator into her vagina allowed Heather to overcome a mental barrier. “I knew I could put the small vibrator in, and all the way in, and I’d get really proud of myself. And my brain got used to it. Dilating can feel so clinical, but once I started seeing results I started doing it four times a week.”
Working through different dilator sizes, and eventually to being able to have penetrative sex with a partner, took time and a lot of mental strength. “Most of my journey was mental,” says Heather. “I told my partner I wanted to have penetrative sex, and he said, ‘You are in complete control’. And that feeling helped, I was controlling every single thrust. I would say, ‘a bit more,’ and then he was fully inside of me.”
Heather still experiences some insertion pain, and believes that this will never fully go away. But, for now, she is happy with where she is, and is proud of her journey.
*This name has been changed
Sarah Berry is the house therapist for The Vaginismus Network, a community and support group for people with vaginismus. Learn more about their meet-ups and contact them
Featured image is an illustration of a woman in her underwear and two dilators of different sizes. She has her back to the camera, with only her torso — from her shoulders down to her bum — visible in the image. Each visual element is framed artistically by a circle
Page last updated May 2020
- NHS, Vaginismus, NHS website, February 2018, [online] (accessed 8 May 2020)
- Lahaie, M.A., et al., Vaginismus: a review of the literature on the classification/diagnosis, etiology and treatment, Women’s Health, 2010, vol 6, issue 5, pp 705-719