What is Vaginismus? Symptoms, Causes, and Treatment

What is Vaginismus?

Do you dread going to the gynecologist because of difficult pap smears? Does painful sex prevent you from achieving healthy intimacy with your partner? Do you find it impossible to insert a tampon? Or maybe you’ve been told you have an “overactive” or “tight” pelvic floor. 

If any of this resonates, you may suffer from a condition called vaginismus, and you are not alone. 

Vaginismus is a common condition and can affect women of all ages, including trans women if a vagina is constructed during gender-affirming surgery1. Recent data suggests up to 17% of those with a vagina are affected, but that number is thought to be underestimated, as many women do not seek help for the condition due to shame or embarrassment2

What is vaginismus exactly? 

Vaginismus (vaj-uh-niz-muhs) is a condition that may cause painful vaginal penetration, thought to be caused by involuntary contraction of the pelvic floor muscles.

What does vaginismus feel like?

The symptoms of vaginismus vary. Many describe the sensation of hitting a “wall” when trying to insert anything into the vagina. Others describe burning, stinging, or tightening of the vagina. For many, vaginismus can manifest as sharp and debilitating pain in the vagina. All the symptoms can cause considerable distress, fear, and difficulty with vaginal penetration. 

Although vaginismus is often discovered when attempting penetrative intercourse, painful sex is not a necessary symptom. Individuals suffering from vaginismus can have difficulty using vibrators or self-stimulating during masturbation, struggle with inserting a tampon for menstrual flow, or resist gynecologist visits because of painful speculum exams. 

If you think you may be affected by vaginismus, or any form of genito-pelvic pain, we recommend discussing your symptoms with your provider to ensure adequate care. 

How is vaginismus diagnosed?

Although many women self-diagnose, it may be helpful to confirm the diagnosis with a medical provider. Unfortunately, there is no definitive test for vaginismus, so providers will first rule out other underlying gynecological conditions. After taking your history, your provider will typically perform an external exam to inspect the area just outside the vagina. Next, your provider will most likely recommend a speculum exam so that they can see your cervix and vaginal tissues. Be sure to communicate with your provider during the exam and let them know if anything causes you discomfort.

Gynecological exams can be distressing and uncomfortable, especially for those with vaginismus. It is important to express these concerns with your provider so they can approach your exam in a trauma-informed manner.

What causes vaginismus? 

Unfortunately, finding a specific cause is not always an easy task. However, some known risk factors for developing vaginismus can include previous sexual trauma, childbirth injury, and hormonal changes.

What can be done about vaginismus?

1. Take a moment to recognize that you are part of a community of women. There are a growing number of resources aimed at connecting individuals who suffer from vaginismus, and the network of support grows all the time.

2. You should tailor your vaginismus treatment to YOU. A big part of learning to overcome the symptoms of vaginismus is getting to know your body and what it needs. Options for treatment of vaginismus include pelvic floor physical therapy, cognitive behavior therapy, use of a vaginal dilator, or a combination of these approaches.

One dilator in particular, Milli, is the first and only all-in-one vaginal dilator that gradually expands the vagina at a pace you control, helping you reclaim your sexual health and relieve the symptoms of vaginismus and painful sex. Milli is also the first FDA-cleared vaginal dilator available over the counter.

Milli is a dynamic vaginal dilator, which means that it provides an all-in-one multiple size option rather than traditional static dilators that come in different sizes. The overall dilation journey is the same, but Milli is a single dilator that expands or retracts based on what you need, when you need it. Milli allows you to gently train your vaginal muscles over time to prepare for a pelvic examination or surgical procedure, and to help sex feel more comfortable.

When using the Milli device or any dilator, include a personal lubricant and vaginal moisturizer like the Mia Vita Personal Lubricant & Vaginal Moisturizer. Using a personal lubricant will aid in natural lubricant and allow ease when using the Milli. To use the Mia Vita Personal Lubricant & Vaginal Moisturizer, insert the applicator to what is most comfortable and dispense the gel. You can also dispense the gel onto your fingers and apply it directly on the device. To maintain healthy vaginal tissue regular hydration with an FDA cleared personal lubricant/ vaginal moisturizer is recommended.

The bottom line is that vaginismus is a treatable condition. With the right combination of education, counseling, and management, most women can break the cycle of pain. That’s why it’s so important to be your own best health advocate and get the help you need. 

By Heather Wheat / Hello Milli


  1. Turner, Kimberly, and Karla Robinson. “What Is Vaginismus? Symptoms and Treatment.” GoodRx, GoodRx, 22 Aug. 2022, https://www.goodrx.com/health-topic/sexual-health/vaginismus.
  2. Spector, Ilana P., and Michael P. Carey. “Incidence and prevalence of the sexual dysfunctions: a critical review of the empirical literature.” Archives of sexual behavior 19.4 (1990): 389-408.
  3. https://hopeandher.com/pages/pregnancy-vaginismus
  4. Goldsmith T, Levy A, Sheiner E, Goldsmith T, Levy A, Sheiner E. Vaginismus as an independent risk factor for cesarean delivery. J Matern Fetal Neonatal Med. 2009 Oct;22(10):863-6. doi: 10.1080/14767050902994598. PMID: 19701866.
  5. https://www.thegoodtrade.com/features/vaginismus-sensate-focus-practices
  6. https://hopeandher.com/pages/frequently-asked-questions#:~:text=The%20cycle%20of%20pain%20triggered,that%20tightens%20the%20vaginal%20opening.
  7. Pacik, Peter T., and Simon Geletta. “Vaginismus treatment: clinical trials follow up 241 patients.” Sexual medicine 5.2 (2017): e114-e123.
About the author
FemmePharma started as a pharmaceutical research and development company more than 20 years ago. We’ve been reinventing women’s healthcare ever since. Please consult your healthcare practitioner to decide which product best meets your needs.

Filed under: Vaginal Health

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