How to Cure Vaginismus with Physical Therapy & Vaginal Dilators

Before therapy, I felt broken. The frustration and sadness from being unable to experience pain-free intimacy weighed heavily on me and my relationship. My partner was incredibly supportive, but I worried he would eventually lose patience. The emotional toll was just as painful as the physical symptoms.

We had many uncomfortable conversations about intimacy, and I often felt ashamed and inadequate. I would avoid situations that could lead to sex, fearing another instance of painful penetration and the emotional distress that followed. My partner reassured me that we would work through it together, but deep down, I worried that my condition would create an insurmountable barrier between us. It wasn’t just about the physical act—it was about feeling disconnected, fearful, and unworthy.

Therapy helped me reframe these feelings. I learned that vaginismus wasn’t my fault, and with time and patience, I could regain control over my body. My partner also became involved in my recovery, supporting me through each step, which ultimately strengthened our relationship. The key was open communication, professional guidance, and the willingness to work through the challenges together.

For years, I had a healthy sex life with no issues. Pain during penetration was never something I had to think about—until one day, it was. At first, I ignored it. Maybe it was stress? Maybe I just needed to relax? But as the pain worsened, I began to dread intimacy. The fear of pain became so overwhelming that I started avoiding sex altogether.

I hesitated to see my family doctor. Part of me was embarrassed—how do you even begin to talk about something so personal? I convinced myself it would get better on its own. But after months of frustration, failed attempts at intimacy, and growing anxiety, I realized I couldn’t ignore it any longer.

When I finally made an appointment, I nervously explained my symptoms to my doctor. She listened with empathy and reassured me that I wasn’t alone. She explained that my symptoms aligned with secondary vaginismus, a condition that can develop later in life due to physical or psychological factors. Instead of brushing off my concerns, she referred me to a pelvic floor physiotherapist, someone who specialized in treating vaginismus.

Walking out of that appointment, I felt a mix of relief and fear. Relief that my pain had a name—and fear of what came next.

Pelvic floor physical therapy helps you develop awareness and control of your pelvic floor muscles , which play a key role in vaginal function. This therapy can relax tight muscles, relieve pain, and reduce penetration anxiety . With the help of a trained physiotherapist, treatment typically includes:

• Kegel exercises to strengthen and engage the pelvic muscles.

• Vaginal dilation therapy , using different-sized dilators to gradually stretch and relax the vaginal muscles over time .

• Manual therapy techniques , including external and internal massage to release tension in the pelvic region.

• Breathing and relaxation techniques to reduce involuntary muscle contractions and fear.

This structured approach helps retrain the body to allow pain-free penetration and can be highly effective for vaginismus recovery.

My first session with a pelvic floor physiotherapist was nerve-wracking. Would it hurt? Would she judge me? But my therapist immediately made me feel at ease.

1. Assessment: My therapist asked about my medical history and symptoms.

2. External Therapy: We started with breathing exercises, posture correction, and relaxation techniques.

3. Internal Therapy: Using gloved hands, she gently assessed my vaginal muscles and introduced vaginal dilators .

4. At-Home Exercises: I was given a dilator set and instructed to practice progressive dilation with relaxation techniques.

Vaginal dilators were my biggest fear—but also my biggest breakthrough. Here’s how I incorporated them into my routine:

✅ Created a calm environment (soft lighting, music, heating pad)

✅ Used plenty of water-based lubricant 

✅ Started with the smallest dilator (about the size of a tampon)

✅ Practiced deep breathing and mindfulness 

✅ Progressed to larger sizes gradually 

✅ Watched Netflix to distract myself and associate the process with relaxation

Over time, my muscles learned to relax. The pain started fading, and for the first time in years, I felt hopeful.

Over time, my vaginal muscles learned to relax. The pain started fading, and for the first time in years, I felt hopeful.

This varies for everyone. Some women see improvement in weeks, while others take months. For me, it took four months of consistent therapy before I could have pain-free sex.

While physical therapy is highly effective, other treatments may help, including:

• Botox injections (to relax the pelvic muscles)

• Topical anesthetics (for pain relief)

• Cognitive behavioral therapy (CBT) (to address anxiety and fear)

• Surgical intervention (in rare cases)

Healing vaginismus wasn’t just about the physical exercises—it was also about learning to trust my body again. The shame, frustration, and isolation I felt before therapy were replaced with confidence and empowerment. But it wasn’t just about me; it was also about my partner and us finding our way back to each other.

Rebuilding sexual intimacy after vaginismus required patience, communication, and a willingness to redefine what intimacy meant for us. We focused on small moments of closeness—cuddling, non-sexual touch, and simply enjoying each other's presence—without pressure or expectations. Over time, as my confidence grew and my body became more receptive, we were able to reconnect both physically and emotionally. Therapy not only helped me heal but also deepened our relationship in ways I never expected.

If you're unsure how to bring up this conversation, check out this guide on how to discuss vaginismus with your partner for practical tips and support.