Vaginismus vs vulvodynia – what’s the difference?

We’ve said it before, but, ladies, we’ll say it again. Sex shouldn’t be painful. Well, unless you’re into that.

But mostly, any kind of unwanted pain with penetration isn’t normal. And neither is any kind of pain down there that happens when you’re not having sex, too. 

Scrolling the SERPs for answers about pain, discomfort, or difficulty with penetration? You’ve probably come across the terms vulvodynia and vaginismus. They’re often mentioned together, and, on the face of it, it’s easy to see why. Both can affect sex, tampon use, pelvic exams, and your everyday confidence. 

They can also feel pretty similar physically, and both can really do a number on your mental health as well. 

Confusion is totally understandable, but we promise that there’s help ahead! And we’re committed to arming you with the right info to take to your provider, starting with a basic 101 on the distinction between vulvodynia vs vaginismus.

Vaginismus vs vulvodynia: what’s the difference?

In simple terms:

• Vulvodynia is ongoing pain, burning, stinging, soreness, or irritation around the vulva. It is described as: “…a chronic pain condition involving persistent vulvar pain lasting at least 3 months without an identifiable cause”. It affects between 10-28% of women. 
• Vaginismus involves the pelvic floor muscles tightening or contracting around the vaginal opening, making penetration difficult, uncomfortable, or impossible. It’s thought to impact between 5-7% of women worldwide. 

Many of you in the community describe vulvodynia as a pain problem (peek at this Reddit subthread), while vaginismus often feels like a tightening, blocking, or “hitting a wall” sensation.

That said, the two can overlap. Pain can lead to muscle tension, and muscle tension can contribute to pain. Both are so valid, and you might even experience features of both conditions.

How do I know if I have vaginismus?

You might first notice vaginismus during activities that involve vaginal penetration, including any of the below:

• Tampons feel difficult or impossible to insert
• Penetrative sex feels blocked, tight, or extremely uncomfortable
• Pelvic exams feel difficult to tolerate
• Your body seems to tense automatically, even when you want to relax
• You feel like you’re “hitting something” during insertion attempts

A really common feature of vaginismus is that you feel your muscles tighten involuntarily. It isn’t something you’re consciously choosing to do, or can easily control.

So if you’re wondering, “how do I know if I have vaginismus?”, think about whether the main issue feels like tightness, resistance, or difficulty with penetration rather than pain on the skin or vulva itself.

And what about the signs that it might be vulvodynia?

Women with vulvodynia often describe symptoms such as:

• Burning
• Stinging
• Rawness
• Soreness
• Irritation
• Pain when sitting, exercising, or wearing tight clothing

For some of us, symptoms might be present most of the time. For others, pain appears when the area is touched, including during sex, tampon use, or medical examinations.

The discomfort is often focused around the vulva rather than feeling like a muscular tightening inside the vagina.

Comparing vulvodynia vs vaginismus, in a nutshell

So what can I do if these symptoms sound familiar?

Start by paying attention to patterns. We love a checklist, and our Notes apps are collectively full of things like this on the team. There’s nothing weird about it at all!

You might find it helpful to note:

• When symptoms occur
• Whether discomfort is pain, tightness, or both
• Activities that trigger symptoms
• Whether symptoms are getting better, worse, or staying the same

These observations can make it easier to describe what you’re experiencing if you decide to speak with a healthcare provider.

The bottom line? Whilst the difference between vaginismus vs vulvodynia isn’t always clear-cut, they are both recognised conditions, and support is out there. 

Your best next step is to reach out to your doctor or a pelvic floor physiotherapist, armed with clearer language to explain your specific symptoms. From there, they should be able to put together a thoughtful, tailored support plan that works for you.

Can vaginismus be cured?

“Can vaginismus be cured?” is a super common question in the TRB community and on Google. Here’s what we know.

The outlook is often positive. Many women see significant improvement with the right support, which may include pelvic floor physiotherapy, education, relaxation techniques, dilator therapy, or other personalised approaches.

Progress looks different for everyone, but vaginismus is highly treatable, and many women go on to experience comfortable penetration.

Also, it can help to know that you’re not alone. Meghan Trainor has vaginismus, and she has been super candid about it which has brought greater awareness to the condition – catch this Tik Tok interview with her, if you haven’t already.

Quick-fire FAQs

Q: Can you have both vaginismus and vulvodynia?

A: Yes. Some women experience vulvar pain alongside pelvic floor muscle tightening. The two conditions can influence each other.

Q: Is vaginismus always painful?

A: Not always. Some women mainly notice tightness, resistance, or difficulty with penetration, while others experience pain as well.

Q: Can vulvodynia make sex painful too?

A: Yes. Pain may occur during penetration, touch, pressure, or friction around the vulva.

Q: When should I see a healthcare professional?

A: If your symptoms are persistent, worsening, affecting intimacy, tampon use, exercise, or your daily life and mental health, it’s always always always worth seeking care. Your provider can help identify what’s contributing to your symptoms and discuss the right treatment pathway for you.

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