What is Vaginismus? with Gráinne Byrne from Norma

Vaginismus is a really common condition where the pelvic floor muscles tense up involuntarily causing pain and difficulty with using tampons, menstrual cups, having smear tests, STD checks and penetration. Vaginismus impacts roughly 1 in 5 people with female anatomy.

The physical issues are really just the start of it though, as vaginismus can have a devastating impact on your self esteem.

It can lead to feelings like:

"I'm not normal"

"I feel broken"

"I'll never be able to have a 'real' relationship"

"My own body is against me"

The good news is that it's really treatable. The thing to note here is the vaginismus is the result of complicated interplay between your brain and your body - it's a stress response taken too far - so successful treatment incorporates both physical and mental aspects. 

Psychosexual counselling, sex therapy, CBT, meditation, physiotherapy and using dilators have all been shown to help.

Healing your vaginismus takes time and involves lots of input from you as you learn how to relax and release your pelvic floor muscles, relieve stress and tension, and resolve any trauma which may be influencing it. 

To honour Vaginismus Awareness Day on the 15th of September, we invited Gráinne Byrne from Norma (intimacy ed that's expert led), to share her knowledge and experience of vaginismus with us. 

Gráinne is a women’s health advocate and health tech entrepreneur based in the sunny south east of Ireland. Her passion is bridging the gap in services and supports in female health and wellbeing, starting with proactive psychosexual therapy and education.

Gráinne started her first company, Norma, because she suffered with vaginismus. She found the experience isolating and frustrating, as frontline healthcare professionals lacked the training to provide effective solutions for such a prevalent issue. 

This experience drove her to take action and create a platform that would empower people with sexual problems to access the care they deserve.

Thanks for joining us Gráinne - so what is vaginismus?

Vaginismus is a condition that affects both the body and the mind. It’s a psychological issue that shows up physically, making everyday things like having sex, getting an internal medical exam, or even inserting a tampon or finger difficult or impossible.

Psychologically, I describe it as a fear of vaginal penetration or sex, specifically a fear of pain upon insertion. This fear can be linked to other conscious or subconscious anxieties, like a fear of pregnancy or of not being in control.

People with vaginismus usually experience a high degree of anxiety around the issue, which causes a lot of tension in the pelvic floor muscles. Over time, this tension leads to the involuntary contraction of those muscles when we try to insert something into the vagina, like a sort of automatic defence mechanism.

The condition is basically defined by this ongoing cycle of fear, pain, and avoiding penetration altogether.

What causes vaginismus?

There are many reasons why vaginismus can develop, and it’s unique to each individual.

Often, people jump to the conclusion that something traumatic must have happened to a person for them to have been diagnosed with vaginismus, but literally anyone with a vagina can develop it.

For the majority, vaginismus is something that starts psychologically. It’s often caused by both a lack of adequate sex education and a stigma around sex itself within their society, culture or religion.

Fear is an extremely powerful contributor to the development and continuation of vaginismus. 

Physical factors that can trigger vaginismus include trauma to the genital area, such as postpartum tears, as well as hormonal changes that lead to vaginal dryness, particularly during breastfeeding or perimenopause.

I also have met many people who have no idea why this is happening to them. It can be particularly confusing for people who have a partner that they trust intimately and they practice safe sex with. 

Who can get vaginismus?

Anyone with female anatomy, at any age, can develop vaginismus. If it’s something you’ve always experienced, it’s known as primary vaginismus. If it develops after a period of no issues, it’s referred to as secondary vaginismus.

The main difference between painful sex (dyspareunia) and vaginismus is that with vaginismus, discomfort or difficulty with penetration (of any kind) tends to persist for 3+ months, making it more likely that vaginismus is the underlying issue at hand. 

What does it feel like?

Many people describe trying to insert something into the vagina or attempting penetrative sex as feeling like they’re hitting a “wall.” If penetration is forced, it can cause a burning or stinging sensation due to the tight contraction of the muscles.

In more severe cases, the pain can feel like shards of glass or a sharp knife pressing into the area. This may sound extreme, but when you consider the thousands of nerve endings in the vulva (with over 8,000 in the clitoris alone), the intensity of the pain makes sense.

How can it be treated?

Treatment for vaginismus depends on the individual’s diagnosis and needs. Most people benefit from a combination of tools, methods, and therapies to help reduce their anxiety around penetration and relieve the underlying tension in their pelvic floor.

If you feel like there’s more of an emotional aspect to your vaginismus, it’s a good idea to see an accredited sex therapist after checking in with your GP. If it feels more like a physical issue with your pelvic floor muscles, visiting a pelvic health physiotherapist is highly recommended. Both professionals regularly treat vaginismus and have high success rates.

One of the most important things I’d suggest for anyone with vaginismus is practicing self-compassion. It’s easy to feel shame or self-criticism when your body isn’t “cooperating,” but these feelings only make things worse. Being gentle with yourself and giving yourself time is key.

Additionally, building self-care routines and exploring alternative therapies that reduce overall stress, like yin yoga, yoga nidra, or acupuncture, can also be helpful in the treatment of vaginismus.

What can people expect at a GP/medical appointment? Any advice on how to prepare for an appointment?

For any GP visit, it’s really helpful to write down what you’ve been experiencing and bring that with you.

Describe your symptoms clearly—whether it’s pain, discomfort, or distress. Include details like the type of pain (e.g., stinging or dull ache), how often it happens, and any changes over time. Make sure to explain how it’s affecting your quality of life, mental health, or relationships, as this helps paint a fuller picture.

It’s important to leave with clear advice and actionable steps. If your GP can’t directly help, ask them who can. And if you don’t feel comfortable with a physical exam, let them know—vaginismus can 100% be diagnosed without an internal exam.

Sometimes women with pelvic pain are dismissed and told to 'just relax' or 'have a glass of wine'. How would you advise people to advocate for themselves if they're met with this kind of advice? 

Advice like “just relax” or “have a glass of wine” isn’t just dismissive—it’s harmful to your health and wellbeing. If a medical professional suggests something like alcohol to manage pain, it’s within your rights to report them to the Medical Council of Ireland or another relevant authority.

Advocating for yourself can be tough, but always remember: you are the expert when it comes to your body. If you feel like the advice or outcome of your appointment is lacking, don’t hesitate to speak up. Let the doctor know that you’re not satisfied and that you expected more clear, actionable guidance.

Are there any barriers to care you'd like people to be aware of?

Barriers to care do exist, especially around women’s health, where conditions like vaginismus or pelvic pain can be downplayed or misunderstood. It’s important to be persistent, seek a second opinion if needed, and don’t settle for advice that doesn’t take your concerns seriously.

Tell us a bit more about Norma - why you started it/ what you do/ how people can access the services.

Norma is a pioneering psychosexual platform offering live, interactive workshops and services focused on sexual wellbeing. I co-founded Norma with the brilliant Clinical Psychologist and Psychosexual Therapist Dr. Natasha Langan.

With only one part-time sex therapist in the Irish healthcare system serving over 5 million people, we created Norma to address the lack of services and provide access to accredited professionals.

We currently run online workshops led by qualified sex therapists on topics like general sexual wellbeing, perimenopause, postpartum challenges, pelvic pain, cancer, fertility, and ADHD/neurodivergence.

Our recent study with the Health Innovation Hub of Ireland found that 2 out of 3 attendees reported improved perceptions of their sexual wellbeing post-workshop, with an impressive average rating of 9.27/10.

We’re eager to partner with organisations to expand these workshops and enhance our platform, ensuring everyone can proactively manage their psychosexual health and wellbeing.

Check out our upcoming workshops at the following link: 

www.feelnorma.com/liveworkshops

If you're struggling with vaginismus, your first port of call is your GP - ask for a referral to a women's health physiotherapist and a sexual therapist.