How do I know if I have vaginismus?


Women often suspect they have vaginismus from their symptoms and ideally will confirm the diagnosis with a physician.


There is no direct test for vaginismus. One of the most important aspects of diagnosis is the thorough elimination of other possible physical or medical conditions that may be causing painful intercourse.


Physicians are sometimes uninformed about the condition and it can be challenging to obtain an accurate diagnosis. Be proactive in educating yourself and seeking answers.

Advocate for yourself

No one understands your pain quite like you. Don't be afraid to share your thoughts and how you are feeling.

Bring a friend

Your mental health matters. Whether you decide to bring a friend or join the online support group, it's important to share your individual experience.



Q: I can wear tampons and have a pelvic exam without issue. Yet, intercourse is painful. Do I have vaginismus?

A: Not all women who have vaginismus have difficulty with pelvic exams or wearing tampons.

Q: What does it mean if the doctor is unable to insert her finger or speculum because my vagina is so tightly closed.

A: Typically, you will be given a diagnosis of vaginismus.

Preparing for your doctor visit

Write out your specific symptoms before the appointment. For example:

  • It happens when... “my husband attempts penetration.”
  • The pain is located... “at the entrance to my vagina. My vagina is like a wall; he just cannot get it in/all the way,” or “after he’s inside I feel burning.”
  • The pain lasts... “as long as he keeps trying, especially if we try forcing it in. Once he stops, there is no pain.
  • This has been happening since... “our honeymoon two years ago and has continued to happen every time we try to have sex” or “my hysterectomy five months ago.”
  • It feels like... “burning, stinging, hitting a wall.”
  • I have tried to reduce or eliminate the pain by... “using lubricant, changing sexual positions, relaxing more.”
  • Mention any other issues current/past… “vaginal dryness, childbirth trauma,” etc.

Easing the exam experience

  • Bring a friend or ask for nurse support.
  • Request the smallest size of speculum.
  • Ask your doctor to describe what is being done as it is happening.
  • Ask to adjust your body positioning for maximum comfort.
  • As much as possible, relax your stomach, thigh, and buttock muscles. Breath slowly and deeply.
  • Speak up in response to overt pain or discomfort, and only continue at your discretion.
  • Distract yourself by focusing on something else like a picture in the room or talking with your support person.

Pelvic exam as part of vaginismus diagnosis

As the process of elimination is a critical part of vaginismus diagnosis, the appointment will typically entail giving a medical and sexual history and undergoing a pelvic/gynecological exam.

The physician will discuss the location and occurrence of pain to help render an accurate diagnosis or may request some other tests to help rule out any other problems besides vaginismus.

What takes place during a typical pelvic exam?

Surgery doesn’t cure vaginismus

Physicians encountering a tight opening may suggest surgery instead of recognizing the presence of vaginismus. Typically, women with vaginismus have normal genitalia. The vaginal muscles simply tighten up and then return to a relaxed state once the threat of penetration is over.

Surgery is not necessary nor helpful in treating vaginismus. The potential for muscle and tissue damage, scarring, and recovery pain of these types of surgeries only leads to more issues.

Sometimes, tightness is misdiagnosed as a hymen problem with a prescribed solution of a hymenectomy. However, hymen problems are rare. By adulthood, the hymen (if still present) is normally thin and elastic and does not prevent intercourse.

Seek a second opinion if any surgery to widen the vaginal opening has been recommended.

Other causes of sexual pain

Some additional causes of painful intercourse are listed below. These conditions can trigger vaginismus, which may persist even after the original condition has been resolved.

  • Eczema/Dermatitis (Vulvar)
  • Endometriosis
  • Interstitial Cystitis
  • Lichen Sclerosus
  • Ovarian Cyst
  • Pelvic Inflammatory Disease (PID)
  • Post-Surgical Trauma/Scarring
  • Psoriasis
  • Sexually Transmitted Diseases (STD)
  • Trauma of Vagina during Childbirth
  • Vaginal Atrophy (Atrophic Vaginitis)
  • Vaginal Irritation
  • Vaginal Prolapse
  • Vulvar Cancer
  • Vulvodynia
  • Yeast Infection