Vaginismus
What is vaginismus? Vaginismus is a condition where the vaginal muscles shut when something is inserted into it. What are the symptoms of vaginismus? You have no control over your muscles shutting and it can make having sexual intercourse impossible. It may also be impossible to insert a tampon and you may experience a burning or stinging sensation in your vagina. What is the trea
What it is
Primary vaginismus is lifelong (penetration has never been comfortable); secondary develops after previously normal function. Causes are usually a combination of muscle conditioning, anxiety, prior negative sexual experience, post-childbirth trauma or undiagnosed vulvovaginal pain syndromes. Treatment is staged: education and reassurance, vaginal dilators, pelvic floor physiotherapy, and (where indicated) psychosexual therapy.
When this is relevant
- Penetration during intercourse is painful, burning, or feels like "hitting a wall".
- Cannot tolerate tampon insertion or speculum examination.
- Avoidance of attempted penetration; relationship strain.
- No identifiable structural cause on examination.
- Coexisting anxiety or other functional pelvic pain syndromes.
How we investigate
Sensitive history, gentle external examination only on first visit (no insertion attempt without consent), screening for vulvodynia / lichen sclerosus / endometriosis, mental health screen.
Options at The Vesey
- Education and reframing - the single highest-impact first step.
- Progressive vaginal dilator programme at home with structured weekly review.
- Pelvic floor physiotherapy with a specialist physiotherapist familiar with vaginismus.
- Psychosexual therapy - particularly where anxiety or prior trauma is contributing.
- Topical lidocaine for initial dilator practice in selected cases.
- Botulinum toxin injection to the pelvic floor - reserved for treatment-resistant cases, by an experienced practitioner.
Can vaginismus be completely resolved? +
Yes. With a structured, staged programme — education, dilators, pelvic floor physiotherapy and (where appropriate) psychosexual therapy — the majority of women achieve comfortable penetration. Primary vaginismus typically takes longer to treat than secondary, but outcomes are good at specialist centres.
Are vaginal dilators safe to use at home? +
Yes, when introduced with structured guidance. We provide a graded dilator kit with clear written and video instructions. Progress is reviewed weekly. The aim is to desensitise the reflex response at your own pace — there is no expectation to rush through sizes.
Is vaginismus the same as vulvodynia? +
They are different conditions but often coexist. Vulvodynia is chronic vulval pain present even without attempted penetration. Vaginismus is the involuntary muscle spasm on attempted penetration. Both can cause painful sex and both are assessed at the initial consultation.
Will I need an internal examination at my first appointment? +
No. At the first visit we take a careful history and, if an external examination is appropriate, this is done with full explanation and consent. Internal examination is never performed without your express agreement — and for many women with vaginismus the first appointment is entirely history-based.
Pricing at a glance
Initial consultation £260 (60-minute slot). Specialist pelvic floor physiotherapy from £85 per session. Psychosexual referral coordinated. Insurance accepted: BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix.
Book an appointment
When to book
Book if penetration has been a problem for more than 3 months, if you have been told "just relax" without a structured plan, or if you want a non-judgmental specialist consultation.
Cost and pathway
Initial consultation £260 (60-minute slot). Specialist pelvic floor physiotherapy via partner from £85 per session. Psychosexual referral coordinated.
- Open 7 days including Sundays — 8am to 8pm, no weekend surcharge
- No GP referral required — book directly with our gynaecology team
- Sutton Coldfield location — serving Birmingham, Walsall, Tamworth, Lichfield and the West Midlands
- CQC-regulated — rated 4.87/5 on Doctify from 700+ verified reviews
View our gynaecology services →
Sutton Coldfield · Birmingham · Walsall · Tamworth · Lichfield · West Midlands · Open 7 days 8am–8pm
Open 7 days · 8am–8pm · 0121 387 3727