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 by 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 non-painful 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 intercourse 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.



The first step in helping women find relief (YES, there can be a resolution of symptoms!) is to run through a detailed history. Some questions I tend to ask my patients include:

1. Have you ever been able to successfully use tampons?

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 sex?

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

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



Kegels are not the solution.

Contracting already tight pelvic floor muscles will likely make it worse and cause further spasming, 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 muscles of the pelvic floor, 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 experience 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.

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