Painful penetration can be frustrating, confusing and difficult to talk about. If penetration regularly hurts, feels impossible, or your vaginal muscles seem to tighten when you try to insert a finger, toy, tampon or penis, vaginismus may be one possible cause.
But pain during sex can have many causes, including vaginal dryness, menopause, pelvic floor problems, infection, endometriosis, childbirth, surgery and some cancer treatments. So rather than trying to diagnose yourself, ongoing or unexplained pain is worth discussing with a healthcare professional.
At Sh!, we've been talking to women about painful sex for decades. This guide explains what vaginismus is, how it can affect sex and penetration, and some of the ways you can explore comfort and pleasure - at your own pace and without making penetration the measure of success.
What Is Vaginismus?
Vaginismus involves the muscles around the vaginal opening tightening involuntarily when penetration is attempted or anticipated.
That tightening isn't something you're consciously choosing to do. It can make vaginal penetration uncomfortable, painful or sometimes impossible, and may affect inserting tampons, having penetrative sex or undergoing some pelvic examinations.
Experiences vary enormously. You might:
- Find inserting anything vaginally difficult.
- Be comfortable using a tampon but find penetrative sex painful.
- Manage some penetration but experience pain or tightening beyond a certain point.
- Experience symptoms only in particular situations.
- Previously have enjoyed comfortable penetration and later develop difficulties.
The important bit? You don't need to push through pain.
If something hurts, stopping is a perfectly good response.
What Causes Vaginismus?
There isn't one single reason someone develops vaginismus.
Physical and psychological factors can both play a part, and sometimes there isn't an obvious cause. Experiences of pain, previous medical procedures, childbirth, menopause, fear or anxiety around penetration and previous sexual trauma may all be relevant for some people.
And sometimes what appears to be vaginismus may actually be another condition causing painful penetration.
That's why self-diagnosis isn't your best starting point.
If penetration is persistently painful or has suddenly become painful when it wasn't before, speak to a doctor, pelvic-health physiotherapist or other appropriately qualified healthcare professional.
I'd completely delete the old traumatic-abuse customer example. You don't need someone else's traumatic experience to make this point.
Primary & Secondary Vaginismus
You may see vaginismus described as:
Primary vaginismus → Penetration has always been difficult or impossible.
Secondary vaginismus → Penetration was previously comfortable or possible but has since become difficult or painful.
These labels can be useful for describing an experience, but everyone's body and circumstances are different.
What Does Vaginismus Feel Like?
There's no single vaginismus experience.
Some people describe:
- Tightness around the vaginal opening.
- Burning or stinging during attempted penetration.
- Difficulty inserting a tampon, finger, toy or penis.
- Being able to manage shallow penetration but not deeper movement.
- Their body seeming to "close up" despite consciously wanting penetration.
- Anxiety around penetration after previous painful experiences.
Pain is information from your body, not something you need to overcome by forcing your way through it.
If penetration causes persistent pain, burning or bleeding, seek medical advice.
Can Vaginismus Be Treated?
There are approaches that can help people experiencing vaginismus, but what is appropriate depends on the individual and the cause of their symptoms.
Support may involve a combination of:
- Pelvic-health physiotherapy.
- Vaginal dilators/trainers.
- Relaxation and pelvic-floor work.
- Psychosexual or talking therapy.
- Lubricants and vaginal moisturisers where dryness is contributing.
- Treating an underlying medical condition.
- Exploring pleasurable touch without penetration.
A healthcare professional familiar with pelvic pain can help you work out what might be appropriate for you.
There is no deadline.
Progress doesn't have to mean reaching a particular dilator size or achieving penetrative sex. Your goal gets to be whatever you want it to be.
How Can Vaginal Dilators Help?
Vaginal dilators - sometimes called vaginal trainers - come in gradually increasing sizes and can be used to explore penetration slowly and with control.
If dilators have been recommended for you, the idea isn't to tolerate progressively more pain.
Quite the opposite.
Start with a size that feels manageable, use plenty of lubricant and give yourself time to become comfortable with that sensation. Move to another size only when you're ready.
Our Sh! silicone vaginal dilator set was designed to make this process feel less clinical and more connected to your body and pleasure. Its soft silicone trainers progress gradually in size, with optional vibration for those who enjoy it.
Sh! tip → If you're using dilators for diagnosed vaginismus, pelvic pain, following cancer treatment or after surgery, follow the guidance you've been given by your healthcare or pelvic-health professional.
Can Vibration Help?
For some people, vibration simply feels lovely, and that's reason enough to use it.
External vibration can also give you a way to explore pleasure without penetration at all. Try a small clitoral vibrator around the vulva, clitoris, thighs or anywhere else that feels good.
If you use vibrating dilators or an internal vibrator, begin gently and explore only sensations that feel comfortable.
You don't have to turn dilation into a medical chore. If adding pleasure makes the experience more enjoyable for you, we're thoroughly in favour.
What Size Toy Is Best for Vaginismus?
If you'd like to explore penetration with a sex toy, think slim, smooth and controllable rather than challenging yourself with size.
Look for:
Slim shapes → Less initial stretch.
Tapered tips → Allow width to increase gradually.
Smooth surfaces → Reduce unnecessary friction.
Soft silicone → Gives more than rigid materials such as glass or metal.
Manageable lengths → Particularly useful if deeper penetration is uncomfortable.
And use plenty of compatible lubricant.
Most importantly, bigger isn't the goal. The right toy is the size that feels good for your body.
Lube, Lube & More Lube
Lubricant can make a huge difference when you're exploring penetration because it reduces friction and adds glide.
A cushioning water-based lubricant is a versatile choice and compatible with virtually all toys.
If vaginal dryness is contributing to discomfort, including during or after menopause, you may prefer something thicker or longer-lasting. A vaginal moisturiser may also be useful for ongoing dryness between sexual activity.
But remember: lube makes comfortable penetration more slippery; it isn't there to make painful penetration tolerable.
If something hurts, don't simply add more lube and push through.
Sex Can Still Be Great
Sex doesn't have to involve penetration.
This is one of the strongest ideas in the original and I'd make much more of it.
If penetration has become associated with pain, taking it off the agenda can create room for pleasure without wondering where every kiss or caress is supposed to lead.
Explore:
- Clitoral and vulval stimulation.
- Vibrators and wand massagers.
- Massage.
- Kissing.
- Nipples and other erogenous zones.
- Mutual masturbation.
- Erotica or audio.
- Touch that doesn't have orgasm as its destination.
- Whatever else feels good and consensual to you.
There doesn't have to be a progression from touch → arousal → penetration → orgasm.
Pleasure can wander wherever you want it to.
Rebuilding Arousal Without Pressure
When penetration has hurt repeatedly, it's understandable if the prospect of "sex" doesn't exactly have you racing towards the bedroom.
So change what sex means.
Take penetration - and perhaps orgasm - off the agenda. Spend time discovering sensations without needing them to lead anywhere.
A small external vibrator can be lovely for this because you can explore your clitoris, vulva, nipples, thighs and other sensitive areas without inserting anything.
If one day you want to explore penetration again, you can.
And if you don't? That's sex too.
When Should I Get Help for Painful Sex?
Speak to a healthcare professional if:
- Pain during penetration is persistent or getting worse.
- Sex suddenly becomes painful when it wasn't previously.
- You experience unexplained bleeding.
- You have persistent burning, irritation or unusual discharge.
- Penetration is impossible or causing significant distress.
- You're unsure whether vaginismus is actually causing your symptoms.
If you've already been diagnosed or are receiving treatment, ask your healthcare professional or pelvic-health specialist whether dilators or other products are appropriate for your particular circumstances.
Moving Towards Pain-Free Sex . On Your Terms
There is no "correct" destination when you're dealing with painful sex.
You may want comfortable penetrative sex. You might want to use a tampon without discomfort, make medical examinations easier, enjoy a toy, reconnect sexually with a partner or simply feel more comfortable and confident in your own body.
Your goal is yours.
Go slowly. Use plenty of lube. Explore pleasure as well as penetration. Get professional support when you need it. And never feel that moving up a dilator size, inserting a penis or returning to the sex you used to have is the definition of success.
Comfort comes first. Pleasure gets a say. And your body sets the pace.
2 comments
Great point Han, we have updated the article :)
What a wonderful hetero/bisexual-orientated article! Would it really be too much for the author to add “or dildo” after the word penis, for those women who are less inclined to keep one nestling in a warm place…