Support for vaginismus in Anna Paulowna

Vaginismus means that the muscles around your vagina and pelvic floor tighten or spasm involuntarily. This can make penetration difficult, painful or impossible. It may occur during sex, but also when inserting a tampon or menstrual cup, or during an internal examination. Vaginismus is not deliberate. Your body responds with tension or protection, even when you do not want it to or do not fully understand it.

There is not always one clear cause of vaginismus. Sometimes it develops after pain, tension, fear, negative sexual experiences, a medical condition, or an unpleasant experience involving intimacy or an internal examination. Stress, control, shame, uncertainty, difficulty sensing your boundaries or earlier experiences of pain may also play a part. Sometimes you do not know exactly where it comes from and mainly notice that your body blocks.

Often no clear physical or medical cause is found. This can be confusing, particularly when you do experience pain, tension or a sense of blocking. But if tests do not reveal anything abnormal, that does not mean your symptoms are not real. What you feel deserves to be taken seriously.

No. Vaginismus is not always related to trauma. Sometimes it can develop after a negative or painful sexual experience, a violation of your boundaries or another distressing event. But this is certainly not always the case. Vaginismus can also develop through experiences of pain, tension, fear of pain, medical symptoms or unpleasant experiences such as an internal examination. Sometimes there is no clear trigger at all and you mainly notice that your body blocks.

It is important to know that you do not need to have experienced a “major trauma” in order to have symptoms. Your body can also build up tension or protection through repeated smaller experiences in which something felt painful, tense, uncomfortable or unsafe.

Stress, tension and long-term overload can affect how safe you feel in your body. If you are under a great deal of pressure, your nervous system may become more active. Your body can then enter a protective state more readily. This may cause your muscles to tighten more, including those in your abdomen, pelvis and pelvic floor.

With vaginismus, this tension can become a kind of negative cycle. Your body tightens, which can make touch and penetration feel more painful. The pain or tension may make you worry, become hypervigilant or brace yourself, which often increases the tension further. Your body may then begin responding more quickly by blocking or tightening, even when you do not want it to. This does not mean that it is “all in your head”. Your body has learnt to protect itself, but at a certain point that protection can also get in the way.

My support pays attention to your body, nervous system, thoughts and feelings. You learn to recognise when your body has been “switched on” for too long and what you need to settle again. This gives your natural capacity for recovery more space and can help greater balance to emerge, physically and mentally and emotionally. This can be supportive alongside vaginismus and the impact your symptoms have on daily life.

Yes. My support does not replace pelvic health physiotherapy or medical treatment, but can complement them. A pelvic health physiotherapist focuses mainly on the physical function of your pelvis, posture, muscles and pelvic floor. In my support, we look at the psychological and emotional layer: what your symptoms do to you, how you navigate them and what tension or stress may be involved. This combination can be valuable precisely because vaginismus is often not only physical.