Is it really psychological?

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    Hello everyone,

    I am 25 years old and suffer from primary vaginismus. (English is not my first language, so bear with me). I have seen doctors and gynecologists, tried dilators and ordered self-help kits online, so far nothing has really worked.
    Doctors are certain that the reason for my vaginismus is psycological, since there is no evidence of any physiological problems. They say, that I need to learn how to control and relax my muscles. (mostly the relax part).

    I am not so sure? I have practiced controlling my muscles so much, and feel that I am completely comfortable with how to tighten and relax them. When I put up a finger I can easily feel that I am doing it right.

    No matter how much I relax my muscles, it still hurts (REALLY BAD) when I try inserting dilators, with a diameter of approximately 1.5cm/0.6inches or more.

    Even though pain makes it more difficult to stay relaxed, I really dont think, that muscle spasms are causing the pain in the first place (if that makes sense?). It feels as if the pain is there no matter how relaxed I am, and the muscle spasms (vaginismus) is a result of physical pain and not psychological fears or anxiety.

    Now, I am not saying that vaginismus is never caused by something psychological, just that I dont think that this is the case for me.

    I just dont know where to go from here, since doctors wont really believe me. They just want me to learn how to relax my muscles, let go and learn that sex is completely ok.

    I really dont think I can improve my muscle-control skills much more and I have never felt that sex is in anyway wrong, been afraid of pregnancy or been the type of person, who is afraid to let go.

    I can simply not identify with the psychological characteristics that they are assigning to me. It feels like I am not really being listened to or taken seriously.

    I would really love to hear if anyone has any thoughts on this? Or maybe some similar experiences?


    Hello Marie2108,

    I am so sorry to hear that you have been continuously told that your issue is all psychological or “in your head.” As a psychotherapist, I am especially frustrated to hear this as I know that no matter how much therapy you have, the issue will not go away until you address the physiological aspects. With vaginismus, the muscles spasms are involuntary and you cannot “think” them away. I am glad that you did try and use dilators which can be the key to your treatment, however it is often difficult to use them without a professional’s help. I am not sure where you are located, but trying to find a specialist in pelvic floor pain or a physical therapist would be ideal. I am sure some other forum members will also share their stories with you, but please know that you are not alone.


    Hi Marie2018 – thanks for your question! I think a lot of us wonder about whether this connection exists between the physical and psychological elements of vaginismus. I found it especially flummoxing and frustrating myself because I didn’t have traumatic experiences in my past, yet I had this triggered physical response that seemed unwarranted.I’ve come to understand that even though I don’t know (and will probably NEVER know) why I had the psychological association between pain and sex, it nonetheless existed.

    It definitely sounds like you’re having a lot of pain when it comes to trying to insert something. I think this is very much possible even when you ARE relaxing your muscles. My personal experience was that I didn’t really understand until treatment just how tense my muscles always were. I was never truly relaxed, and the spasm was so involuntary that in a way I wasn’t aware of it because I didn’t have a calm state. I’m sure your experience is different than mine, but in my experience, the psychological effects of vaginismus don’t necessarily feel like being traumatized or triggered – they can just be holding you back in a way you can’t even identify until you are treating them.

    I second what Nicole said – a pelvic floor specialist or physical therapist would probably be able to really help you with the physical issues of your vaginismus. I applaud you for all the work you’ve done so far – it’s hard to confront vaginismus, and you’re very brave for doing so!



    Welcome to the forum! I’m so so sorry to hear about your issues with penetration and your attempts with dilators, but it’s great that you’ve found this forum. I also can understand your confusion with the psychological side of vaginismus and your dismissive doctors – the physical pain IS ABSOLUTELY REAL and should not just be blamed on psychological issues.

    I reeeeally relate to your post and I think that you might feel comfort in knowing that I was in an extremely similar boat and WITH THE HELP OF A SPECIALIST, I got through dilation therapy (I went to Maze Women’s Health, but as Nicole & recessivegenequeen said, another pelvic floor pain specialist/women’s center can help). I got through all sizes of dilators a much more confident and strong person – and it was obviously the hugest weight off my shoulders to not feel so anxious and worried about sex – I can’t even describe the relief!

    Like you, I was unable to use dilators on my own when I bought them. Instead of giving up, which I kinda wanted to do sometimes, I eventually went to Maze Women’s Clinic in NYC. I still was unable to use the dilators the first couple sessions because of extreme fear of the pain, but I worked with their therapist and their health practitioner and eventually overcame my vaginismus.

    This comes from me being a very difficult case – I couldn’t wear tampons from the pain/fear, and the thought of dilating with even the smallest dilator gave me immense fear. The physical portion of the first couple appointments were so nerve-wracking; I was prescribed Xanax to take before each following appointment. Yes, dilators can hurt a bit (coconut oil as lubricant helps!) but with the help of the specialist, I learned to go very slowly so the insertion didn’t hurt too much, and I was taught some deep breathing exercises that also helped. Mostly, the specialist helping me insert them & giving me the confidence that I *could* fit the dilators in (even if uncomfortably at first), was what helped me get through the physical therapy (this may be the psychological portion for me).

    It can be a stressful journey, but I am confident that with the right support you WILL be able to use dilators and that they will help you overcome your vaginismus.

    I wish you luck with your journey. If you ever need someone to chat with, I would be happy to e-mail you back and forth through your journey!

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