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Painful Vaginal Penetration- Causes and Treatment

Painful Vaginal Penetration- Causes, TreatmentWhen a woman’s vagina muscles squeeze or contract when something (penis, tampons, etc) is entering into it and it feels slightly uncomfortable and painful, it is a sign of a genito-pelvic disorder called Vaginismus Painful Vaginal Penetration- Causes and Treatment.

Vaginismus sometimes called vaginism is a condition that affects a woman’s ability to engage in vaginal penetration, including sexual intercourse, manual penetration, insertion of tampons or menstrual cups, and the penetration involved in gynaecological examinations (pap tests). This is the result of an involuntary vaginal muscle spasm, which makes any kind of vaginal penetration painful or impossible.

Depending on the force, vaginismus symptoms range from minor burning sensations with tightness to total closure of the vaginal opening with impossible penetration.

Painful Vaginal Penetration- Causes, Treatment


For many women, vaginismus just happens; unexplained tightness, discomfort, pain, and entry problems are unexpectedly experienced during penetration attempts. This occurs without the conscious intent or control of the woman; it can be very difficult to control. It is important to note that vaginismus is not the woman’s fault.

Reacting to the anticipation of pain, the body automatically tightens the vaginal muscles, bracing to protect itself from harm. Penetration becomes uncomfortable or painful, and entry may be more difficult or impossible depending upon the severity of this tightened state. With attempts at penetration, any resulting discomfort further reinforces the reflex response so that it intensifies more. The body experiences increased pain and reacts by bracing more on an ongoing basis, further entrenching this response and creating a vaginismus cycle of pain.

Examples of Non-Physical Causes

  • Fear: Fear or anticipation of penetration pain, fear of not being completely physically healed following pelvic trauma, fear of tissue damage (i.e. “being torn”), fear of getting pregnant, concern that a pelvic medical problem may reoccur, etc.
  • Anxiety or stress: General anxiety, performance pressures, previous unpleasant sexual experiences, negativity toward sex, guilt, emotional traumas, or other unhealthy sexual emotions
  • Partner issues: Abuse, emotional detachment, fear of commitment, distrust, anxiety about being vulnerable, losing control, etc.
  • Traumatic events: Past emotional/sexual abuse, witness of violence or abuse, repressed memories
  • Childhood experiences: Overly rigid parenting, unbalanced religious teaching (i.e.”Sex is BAD”), exposure to shocking sexual imagery, inadequate sex education
  • No cause: Sometimes there is no identifiable cause (physical or non-physical)

 Examples of Non-Physical Causes

  • Medical Conditions:Urinary tract infections or urination problems, yeast infections, sexually transmitted disease, endometriosis, genital or pelvic tumours, cysts, cancer, vulvodynia / vestibulodynia, pelvic inflammatory disease, lichen planus, lichen sclerosus, eczema, psoriasis, vaginal prolapse, etc.
  • Childbirth: Pain from normal or difficult vaginal deliveries and complications, C-sections, miscarriages, etc.
  • Age-related changes: Menopause and hormonal changes, vaginal dryness / inadequate lubrication, vaginal atrophy
  • Temporary discomfort: Temporary pain or discomfort resulting from insufficient foreplay, inadequate vaginal lubrication, etc.
  • Pelvic trauma: Any type of pelvic surgery, difficult pelvic examinations, or other pelvic trauma
  • Abuse: Physical attack, rape, sexual/physical abuse or assault
  • Medications: Side-effects may cause pelvic pain

Treating Vaginismus

Vaginismus is highly treatable, and treatment does not require drugs, surgery, hypnosis, nor any other complex technique. Effective treatment approaches combine pelvic floor control exercises, insertion or dilation training, pain elimination techniques, transition steps, and exercises designed to help women identify, express and resolve any contributing emotional components.

Women with vaginismus should engage in Kegel exercises, in the privacy of their own home, to learn to control and relax the muscles around the vagina.

The approach is called progressive desensitisation, and the idea is to get comfortable with insertion.

Kegel exercises should be done by squeezing the same muscles you use to stop the flow of urine when urinating:

  • Squeeze the muscles.
  • Hold for 2 to 10 seconds.
  • Relax the muscles.

Do about 20 Kegels at a time. You can do them as many times a day as you want to.

For women whose vaginismus is related to fear or anxiety, therapy helps.

Victoria Haruna


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