How Can Physical Therapy Treat Vaginismus?


Vaginismus is a condition linked to anxiety and fear of having sex which leads to pelvic pain and painful intercourse. The thought or act of vaginal penetration creates an automatic response, or spasm in your pelvic floor muscles, creating discomfort and pain.

Medical professionals often look for a physical problem to fix and may even advise surgery. Please seek a second opinion, just in case! You do not need surgery to address vaginismus.

There are two types of vaginismus:

  • Primary vaginismus (also known as lifelong vaginismus) happens when a woman experiences pain every time something attempts to enter her vagina.
  • Secondary vaginismus (also known as acquired vaginismus) occurs when a woman has had pain-free sex but is now experiencing pain.

What causes vaginismus?

There is no definitive cause for vaginismus, but the condition is linked to anxiety and fear of having sex. You may be experiencing pelvic pain due to vaginal penetration because:

  • You’re afraid that your vagina is too small.
  • Your first sexual encounter was uncomfortable or painful.
  • You’ve had bad experiences during medical examinations.
  • You believe sex is shameful or even wrong in some circumstances.
  • You have a medical condition that affects your pelvic floor or vagina.
  • You’re experiencing vaginal dryness.

Your pelvic floor cannot relax and, over time, will become uncomfortable until you lose your desire to have penetrative sex.

If you’re not sure that you are experiencing vaginismus, determine if you’re experiencing the following:

  • Pain upon inserting a tampon.
  • Difficulty with penetrative intercourse.
  • Burning, stabbing, or stinging during sex.


How can a pelvic health PT help with vaginismus?

Our pelvic health physical therapists can help reduce your pelvic pain due to vaginismus. After taking your history and completing an orthopedic and pelvic floor examination, they can create personalized pelvic floor programs to help you reach your goals.

They can perform internal pelvic floor examinations but will work with you and your abilities. So, if you can not tolerate vaginal penetration, they are trained to assess your pelvic floor externally.

What treatments does PT use for vaginismus?

Vaginal dilators, or tubed-shaped devices, help you gently stretch and manage your pelvic pain. 

Dilators come in various shapes and sizes, so you can find a set that best fits your needs and is comfortable for you. You start with the smallest size and work your way up to a thicker diameter and deeper insertion, typically for 20-30 minutes, in a quiet, relaxed space.

There are many tools a pelvic health physical therapist can teach you to use other than vaginal dilators, such as:

Our pelvic floor physical therapists will guide and support you until you are comfortable with progressing to the next step or are able to continue your program at home.


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