What is Vaginismus? How physiotherapy can help your symptoms

Have you ever found it difficult to…

Insert a tampon?

Undergo a PAP smear?

Or have penetrative intercourse?



Vaginismus is a penetration disorder whereby women experience persistent difficulty with achieving vaginal penetration. It is often characterised by the involuntary contraction of the pelvic floor muscles in response to physical contact or pressure which prevents pain free sexual intercourse and may cause the vaginal entrance to appear smaller. Read more about pelvic and sexual pain.

The incidence of vaginismus is varied with research reporting as low as 5% and up to 20% (Spector & Carey 1990). However, these stats may be conservative due to fear or embarrassment in expressing concerns or challenges.


Vaginismus is typically classed as either primary or secondary.

  • Primary Vaginismus refers to the condition when a female has never had comfortable penetration and, in some cases, has never achieved penetrative sex which can have implications for the consummation of marriage and fertility.
  • Secondary Vaginismus occurs after a period of normal sexual relations prior to the onset of symptoms. For example, this may occur after a traumatic event such as abuse or having a baby.

Whilst there is a subset of women whose symptoms stem from physical or psychological abuse or a conservative upbringing, for some women the underlying cause may be a reaction to medical conditions such as Endometriosis, hormonal fluctuations, UTIs, recurrent Thrush or Constipation. And in some women, there may be no identifiable cause whatsoever.


Whilst there is a subset of women whose symptoms stem from physical or psychological abuse or a conservative upbringing, for some women the underlying cause may be a reaction to medical conditions such as Endometriosis, hormonal fluctuations, UTIs, recurrent Thrush or Constipation. And in some women, there may be no identifiable cause whatsoever.



The first step in helping women find relief (YES, symptoms of vaginismus can be resolved) is to run through their medical and sexual history. Some questions I tend to ask my patients include:

1. Have you ever been successful with inserting a tampon?

2. Have you ever had sexual intercourse or penetration of any kind?

3. Have you had a history of abuse (sexual, emotional, physical) that you are aware of?

4. Have you had recurrent yeast infections or UTIs?

5. Do you have a history of painful or difficult periods?

6. Are you fearful of vaginal penetration?

After this, I often talk ladies through the Vaginismus cycle of pain.

image: Hope & Her (www.vaginismus.com)



Kegel exercises are not the solution.

Contracting already tight pelvic floor muscles will likely make it worse and cause muscle spasms, perpetuating the cycle (as shown in the above image). A Women’s Health Physiotherapist will guide you on how to relax the muscles, including manual therapy to relax the pelvic floor muscles, tummy, buttocks, legs and back, teach you stretches, introduce graded touch and tissue desensitisation techniques and recommend a dilator program. We also discuss other approaches to a fulfilling intimate relationship whilst undergoing treatment. In some instances, dry needling or botox may be helpful to relax these muscles too and usually is performed by a doctor, and is considered later down the track.


It takes a village…

A team approach is the best approach. Working alongside your doctor we help identify the best course of treatment for you. I encourage women to seek the support of a psychologist or sex therapist to help address any fear or anxiety.

Where possible, I highly encourage ladies to discuss and be open to their partners about their experiences and journey.

And, I do stress that it is a journey not a sprint.

If you are experiencing symptoms of difficult penetration, please call/WhatsApp on 9780 7274 or get in touch over email to make an appointment. It’s common, not normal and help is available.

You can also visit our website to learn about other women’s conditions we treat through physiotherapy and how we can help you.

Note: Although I am a Physiotherapist, I am not YOUR physiotherapist. Information contained on this website is for informational purposes only and is not intended to serve as individual medical advice.


Spector, IP & Carey, MP 1990, ‘Incidence and prevalence of the sexual dysfunctions: a critical review of the empirical literature’, Arch Sex Behav, vol. 19, no. 4, pp. 389-408.

5 Star Google Reviews
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My experience with embrace from start to finish was nothing short of professional, warm and understanding. After my third pregnancy, I had lots of dull, heavy tugging pain low in my abdomen. I had also been suffering for years with urinary hesitancy. Went to so many different doctors and specialists to find out what was causing it, with no luck. It was only when I chanced upon embrace’s blog did I get some insight (or even awareness at all) into women’s pelvic health. I wrote in to enquire, and my worries were met with assurance and suggestions, at no cost. Preet is friendly, approachable and made me feel comfortable throughout what could have been an embarrassing therapy. It was so comforting to finally be heard, understood and not dismissed as “this is normal” the way all the doctors had. No amount of reading up compares to having real time feedback with kegels by a trained professional. 6 months in and I feel a world of difference! If anyone out there feels any less about her body after pregnancy or feels pain or discomfort in any way, or resorted to accepting “this is my new normal”, trust me you’re not alone. If you’re living in the east, I’d recommend embrace physiotherapy. They don’t pressure you to commit to regular sessions at all. No harm giving it a shot!

ayshaalkaff Avatar ayshaalkaff
June 27, 2022

Saw Preet first to fix my postnatal pelvic floor issues and then Brenda to get me back to regular exercise without injury. Both have been nothing but awesome. They're professional and empathetic, and I've always felt listened to and in a safe space. I spent most sessions with Brenda and she targeted every ache and niggle with a good solution. I also love that it's women only, too bad for the boys!

W Wong Avatar W Wong
September 21, 2022

It is so amazing to have this wonderful clinic in the East! (no need to go traipsing into the hospital areas/zones to access amazing care). I started seeing Preet at Embrace during the second trimester of my pregnancy. She's a really gifted physio - the kind who provides great treatment as well as in-depth information, underscored by excellent communication skills. She really helped to relieve the pain I was experiencing. I have since received post-natal care at Embrace and have also started going to their weekly pilates classes, which are targeted for women. It makes all the difference to have a pilates teacher who's already aware of all your physio requirements! 5 stars!

Kirrilee Hughes Avatar Kirrilee Hughes
November 8, 2021

Embrace life. Embrace Physiotherapy.

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