Vaginismus (insertion pain)

Vaginismus is the name for when the vaginal opening suddenly tightens up when you try to insert something into it e.g. a tampon, menstrual cup, or during sex [1]. It can be painful and unsettling but the good news is that it is usually very easily resolved!

Vaginismus is the body’s automatic reaction to the fear of some or all types of vaginal penetration [1]. Whenever penetration is attempted, the vaginal muscles tighten up on their own, the individual has no conscious control over it [1]. An individual can develop vaginismus even if they’ve not previously had a problem with vaginal penetration [1].

Other conditions that can also cause pain in the vaginal opening:
  • Vulvodynia– persistent, unexplained pain in the vulva (the external female genital area).
  • Thrush – a common yeast infection that causes itching, pain, and a creamy thick discharge.
  • Sexually transmitted infections – if you have had unprotected sex, this is a possibility- it’s best to go for regular sexual health checks (an encourage your partner to do the same).
  • Menopause – a reduction in vaginal fluid at menopause can result in painful vaginal penetration, usually easily solved through the use of vaginal lubricants
  • An allergic reaction to condoms (latex), soap or shampoo- alternative products are available. Note- the vagina is self-cleaning and can react badly to douching, or the use of soaps. Only use soap on the vulva (external part of the female genitalia), never inside the vagina. If you notice a ‘bad smell’, this is probably due to a (very common) vaginal infection.
  • Pelvic inflammatory disease– an infection of the female upper genital tract, including the womb, fallopian tubes and ovaries.
  • Endometriosis severe period pain caused by internal bleeding and inflammation.
  • Fibroids– non-cancerous growths that develop in the lower abdomen (usually around the womb), sometimes causing abnormal bleeding, and pain.
  • Physical injury– cuts, bruises, and inflammation in the vulva (external part of the female genitalia) can all result in pain.

Main symptoms: anxiety, pain.

Note: Vaginismus is not really a hormone-related symptom, but it is a condition connected to the female reproductive system, and can have an impact on health and wellbeing. It can also make it difficult to use internal menstrual management products, e.g. menstrual cups, which can have an impact on an individual’s ability to take part in sports or other social or work activities, as well as their self-esteem.

The NHS recommends that you see your GP, or go to a sexual health clinic, if;

  • you find it very hard, or painful, to insert an internal menstrual management product e.g. tampon or menstrual cup
  • you struggle with vaginal penetration during sex
  • you feel burning or stinging pain during sex

These are all common signs of vaginismus [1]…

What happens at your appointment

You can ask to be seen by a female doctor and you can bring someone you trust along for support. Your doctor will ask you about your symptoms and may ask to examine your vagina. The examination is usually very quick. Your doctor will take a quick look to rule out other conditions, like an infection.

It’s unlikely they’ll need to perform an internal examination of your vagina. If your doctor thinks you’ve got vaginismus, you may be referred to a specialist, such as a sex therapist [1].

Treatment for vaginismus

Treatment usually focuses on:

  • managing your feelings around penetration
  • exercises to gradually get used to penetration
Possible treatmentsDetails
Psychosexual therapya type of talking therapy that aims to help an individual to understand and improve their feelings about their body
Relaxation techniquesmindfulness, breathing and gentle touching exercises to help to relax the vaginal muscles
Pelvic floor exercisessqueezing and releasing exercises to gain control of the vaginal muscles
Sensate focusexercises to help with relaxation during sex
Vaginal trainerssmooth tampon-shaped objects in different sizes to help you gradually get used to vaginal penetration

Treatment is initially done under the guidance of specialised therapists. You will then usually be expected to practise some the exercises at home. Treatment is usually effective and you may see progress in a matter of weeks [1]. You can also try relaxation techniques and get to know your own body better, yourself, at home.

Further information:

  1. NHS page on vaginismus-
  2. This website all about treatments for vaginismus –
  3. Vaginal lubricants to help with the physical effects of vaginismus e.g. Yes organic lubricants-

Page last reviewed and updated: June 2018


  1. NHS. (2018) Vaginismus. [ONLINE] Available at:  [Accessed 27 Feb 2018]