Causes of Vaginismus

A major factor in resolving vaginismus is having the understanding of what is actually causing it. There is a lot of conflicting . . . and simply incorrect information and literature out there on the causes of vaginismus. I hope this webpage will help to give you more accurate and useful information about the symptom, and what is needed to effectively resolve it.

Causes of vaginismus – it’s above the neck, not below the waist…

Although vaginismus manifests itself as a physical problem, it is caused by psychological and emotional factors.

So many of the women that I have treated for vaginismus initially attributed the symptom to a physical abnormality, believing that there must be something wrong with their vagina. It could be that they believed their vagina was simply too narrow, too shallow or their hymen was preventing penetration. The reality is that vaginas are stretchy and elastic – when the minds they are connected to are relaxed! I have worked with clients who have spent many years doing physiotherapy exercises to overcome their vaginismus. Some have used botox to try and relax the muscles. Others have had surgery on their vaginas . . . and still have vaginismus.

Our mind is an remarkably powerful contraption and the thoughts we create can have an incredible impact upon our body. Simply with the power of our imagination we have the ability to create a whole host of physical sensations: we can make our heart race by thinking of a frightening situation; we can create a headache by feeling stressed. By the same token, simply the dread and fear of penetration can have a massive impact upon how your body will respond to that very thing.

We have thousands of them every day and most of them occur without our awareness. After all, our thoughts become ‘normalised’ so that we don’t even notice what we are occupying our minds with. However, although unnoticed, these thoughts ARE having a big impact upon our emotions and our body. Making you aware of the cognitive processes that are causing the vaginismus is the first major step towards resolving the problem.

What vaginismus is NOT caused by…

This may be a little challenging or controversial, but every piece of literature I’ve ever read on vaginismus suggests that some or all of the cases of it may be caused by past events. This is simply not true.

It is commonly suggested that vaginismus may be caused by such factors as:

  • Sexual abuse or negative sexual experiences
  • Strict parenting
  • Religious teachings
  • Hearing tales when you were a child or teenager of how painful sex will be, how much you’ll bleed, that it might get stuck…

However, none of these factors are the DIRECT cause of vaginismus. There is no correlation between sexual abuse and vaginismus (and I have treated many women who have been sexually abused who don’t have vaginismus). Likewise, many people have had strict parenting or religious teaching and don’t go on to get vaginismus.

As my ex-vaginismus client Lisa says:

“I also started working with a sexual psychotherapist just a few weeks before I started working with Cara. This was unhelpful because she pin pointed the cause of my problem to my childhood. I now realise that she had very little understanding of vaginismus and if I kept seeing her would have probably caused more damage. Thankfully I met Cara who steered me in the right direction and advised that I stop seeing the psychotherapist which I am now so unbelievably thankful that I did.”

To explain further, very few people who’ve been in a car crash go on to develop a phobia of driving. Similarly, all the millions of people in the world with a phobia of snakes or airplanes have never actually been bitten by a snake or been in a plane crash. There is not a direct cause and effect relationship between past events and resulting symptoms. The crucial mediating factor is how we respond to events…

Symptoms, including vaginismus develop, not because of events, but our reaction to them

As I mentioned previously, the causes of vaginismus lay in our current day thinking and beliefs about penetration. When we are unaware of those it can be easy to attribute the problem to an external experience or circumstance and conclude that “this experience or person has MADE ME have vaginismus”. However, the past has been and gone – we cannot change it.

The first step to overcoming vaginismus is to ask yourself the more empowering question “How are my current thoughts maintaining the symptom?”

Some common beliefs and behaviours that cause vaginismus

The Misuse of the imagination

When you imagine having sex or any form of penetration, you will probably ‘catastrophise’ and imagine it hurting and being unsuccessful. Perhaps you imagine your vagina being too small or simply just an impenetrable brick wall. The beliefs we create originate from the thoughts we think, so if you are imagining pain, blood, tears and failure, no wonder you are tensing up. This leads to an unhelpful cycle of behaviour:

Imagine pain → body tenses → penetration is painful/impossible→reinforces unhelpful beliefs→imagine pain → body tenses, etc etc.

I have worked with ladies who could feel vaginal pain simply by imagining penetration.


When penetration seems so difficult to achieve and failure seems so likely, it can be easy to avoid even attempting to have a successful outcome. It can seem like such a huge, insurmountable problem that you have given up trying, leading to feelings of even more helplessness and failure.

Social Anxiety

If you feel self conscious, inhibited or judged by your sexual partner, this will lead to anxiety and feeling uncomfortable in the bedroom.

Self consciousness: Having worries about what you look like naked, noises you might make or how you smell. These are the least sexy thoughts to occupy your mind with in the bedroom!

Resentment towards your partner or fear of disappointing/angering him: If you are emotionally closing down, then your body may do the same.

Effective treatment of vaginismus lies in giving you the self insight to understand how your current thinking and beliefs are causing the condition.  Resolution lies in teaching you how to acheive psychological and emotional control, and not only in the bedroom, but in all areas of your life.

This is achieved through the brilliant Thrive Programme, details of which can be found HERE

As shy or awkward as you many feel, it is prudent to seek a medical professional’s opinion if you think that your vaginismus may be caused by a physical issue. Occasionally, vaginismus has a physical cause, such as a yeast infection. Being able to eliminate this possibility will help you to focus your search for a cure in the correct direction.