Vaginismus FAQs

Vaginismus (also known as vaginism) is a sexual problem affecting women. It causes penetration to be painful or impossible due to the tensing of the vaginal muscles. Sufferers may also experience anxiety and difficulty inserting tampons or undergoing gynaecological examinations.

It is an emotional and psychological condition. The causes of it are psychological, although it manifests as a physical condition. This vaginal tightness may cause sexual discomfort or pain, burning or tearing sensations, and inability to have sex or insert any object into your vagina.

Vaginismus is the main cause of unconsummated relationships, and it can put relationships under great strain. It is extremely frustrating to be unable to physically engage in pleasurable sex and sufferers often feel abnormal and embarrassed about the condition. The anticipation of pain or sexual ‘failure’ further contributes to and reinforces the symptoms of vaginismus. This can lead to avoidance of penetration and a feeling of alienation from ones own body as the vagina becomes a no-go zone. This exacerbates negative emotions such as feelings of failure, or general squeamishness about ones vagina.

PRIMARY VAGINISMUS where the woman has never experienced full pain-free penetration.

SECONDARY VAGINISMUS is where the woman was previously able to have pain-free penetration. It can occur after her having had some sort of medical condition that caused sexual pain such as long-term cystitis and, although the original condition is no longer present, her fears about penetration continue.

It can also be triggered by issues in her relationship with her partner. Resentments outside of the bedroom may result in her distancing herself (even unconsciously) in the bedroom. 

Peri-menopausal and menopausal vaginismus, often due to a drying of the vulvar and vaginal tissues as a result of reduced estrogen, may occur as a result of "micro-tears" first causing sexual pain then leading to vaginismus.

SITUATIONAL VAGINISMUS - This occurs only in certain situations or with certain partners. The occurrence of it may seem entirely random and unpredictable.

It’s impossible to know how many women suffer from this condition as there exists no centralised body that collates information on vaginismus. Many women suffer in silence and feel too embarrassed to tell their doctor. The water is further muddied by incorrect diagnoses from doctors and other specialists.

I personally receive many enquiries every day from women with the condition. Hopefully you will find this reassuring as it can be easy to believe you’re the only one suffering from this problem!

Ideally, you should visit your GP go to a sexual health clinic if you think you might have vaginismus. You may feel embarrassed about seeking help, but it is important to be able to rule out other possible physical causes of any symptoms. If your doctor suspects vaginismus, they may be able to refer you to a specialist, such as a gynaecologist. There are many specialists out there and a knowledgeable and astute specialist will be able to correctly diagnose the problem.

It is likely that you have vaginismus if you experience some or all of the following:

• You feel very anxious or fearful at the thought of penetration.
• You feel alienated from your vagina.
• You feel a sense of squeamishness or disgust towards your vagina.
• You avoid penetration due to fear of pain or other negative emotions. This may include avoidance of tampons, sex or gynaecological examinations.
• You feel as though there is a ‘wall’ or other obstacle inside your vagina preventing penetration or you imagine your vagina to be abnormally narrow.
• You experience a burning or stinging pain and tightness of the vagina if penetration occurs. This can range from mild discomfort to extreme, unbearable pain.

It's a common misconception that vaginismus is caused by a past sexual trauma. However, my own experience of working very closely with hundreds of women is that the vast majority  are women with unremarkable sexual pasts.

Many are religious, although having a religious background isn't a direct cause of vaginismus. There are plenty of religious women who don't develop vaginismus.

However, what I have learned is that women with vaginismus tend to be: 

• Overthinkers and worriers
• Disconnected and alienated from their vaginas
• Perfectionists who can often put themselves under pressure (particularly about 'performance' or 'on the spot' type situations)
• Women who dislike or avoid out-of-control type situations (and penetration can be considered such a situation)
• Fear of getting things wrong, fear failure, and judgement from others

It is your current mindset and beliefs and that cause the physical responses behind vaginismus. Which is great, because you can change all of these! See the Vaginismus-Free Programme here.

It can be easy to attribute vaginismus to a physical abnormality if you don't have the necessary insight and understanding as to how you are creating the muscle tension with some unhelpful thoughts and beliefs.

Most vaginismus sufferers look ‘externally’ for why they have the symptom: believing it must be due to past experiences or that there must be something wrong with your body.

It is these beliefs that make you feel powerless and helpless in overcoming the problem (because you can't necessarily change these things). The key to resolving vaginismus is to look more ‘internally’, ie, how could my beliefs and thinking TODAY be causing the physical tightness - for that is where the true answer lays.

Data from 25 of Cara's clients (in November 2024) reveals that when they first began the programme, 52% believed their was something physically wrong with their body. At the end of the programme, NOT ONE woman believed that.

Most of my vaginismus clients had tried other interventions before coming to see me, sometimes investing a great deal of time and effort. These range from psychosexual therapy, physiotherapy, Kegel exercises, Botox injections, all the way through to trying voodoo (quite literally!). However, these interventions often do not fully address the REAL causes and components of the condition. It’s then understandable that when they fail, the woman is left feeling even more hopeless and the belief that vaginismus is very hard to overcome is reinforced.

Vaginismus is NOT difficult to overcome - as long as you focus your efforts in the correct direction. A good analogy for this is if you were to lose your car keys in the garden, you could search endlessly in the house but will never find them. It's not that they are difficult to find, but you have to search in the right place.

It can be easy to believe that it can take a long time to overcome vaginismus - especially if you have already had it for a long time and the interventions you have tried have been unsuccessful. However, the great news is that with the RIGHT treatment, it is entirely possible to fully overcome vaginismus in 8-12 weeks.

Absolutely not! In order to have vaginismus, there are some very specific psychological process going on behind the scenes which cause the tensing of the vaginal muscles. No one ever taught you how to manage your thinking well. No one ever taught you how to create strong beliefs. No one taught you how to control your thinking, or about the mind-body connection. Without these invaluable insights it's no wonder that problems can arise in life. So no, you're NOT a failure and it's not your fault that you are struggling right now!

Many women mistakenly believe that vaginismus is purely a physical issue — that it’s all about tight muscles and physical pain.

So, they turn to physical solutions like Botox injections, hoping that’ll ‘fix’ the problem.

But here’s the truth: Vaginismus is never just a physical problem. And the real fix doesn’t come from needles.

Botox can temporarily relax muscles, but it doesn’t address the deeper, underlying reasons for your body’s response.
It doesn’t teach your body to feel safe.
It doesn’t eliminate the fear or tension that keeps you stuck.

You need a solution that is physical AND psychological — one that involves your mind, your beliefs, and your emotions.

Because when you feel confident and in control of your body everything changes.

My past student Olivia, 24, had this to say:

"I thought that I had an incredibly complex issue that could only be treated with Botox. Thats when I found the Vaginismus-Free Programme and contacted Cara – the rest is history!

With Cara’s help, I was able to overcome Vaginismus, enjoy sex and have a full gynecological test – something I had been too afraid to do before."

So many women with vaginismus have a box of dilators gathering dust at the back of their wardobes! However, with the correct training, they can provide you with an essential yardstick to practice and measure how much you can relax your vaginal muscles.

This will hugely boost your confidence about what your vagina can accommodate. If you are single and are not in a position where you can put your learnings into practice with an actual human, the dilator provides an good substitute measuring tool. Dilators will save you the time and effort of having to find several boyfriends with varying-sized penises.

Ask your doctor for recommendations or do your research and buy a set online in Boots or Amazon. 

Ideally, the set should contain four or five dilators of varying sizes, and they are generally either plastic or silicone. The plastic variety are usually cheaper in price, but you may prefer the silicon ones for their more 'organic' and warmer feel.

Vaginismus only returns if it wasn’t fully resolved in the first place. Sometimes, even after physical progress, certain  vaginismus-type thinking or underlying beliefs can remain quietly in the background, and over time, they can resurface.

It’s a bit like weeding a garden: if you only pull the weeds out at the surface, they’ll eventually grow back from the roots. The same applies here - the key is addressing what’s underneath, not just what you can see.

That’s why the Vaginismus-Free Programme goes beyond the physical side. It helps you feel truly powerful and in control of your body and how it responds. Once that shift has happened, vaginismus can’t return.