It often starts with something small. A tampon that won’t go in, no matter how carefully you try. A sense that you reach a point — and then a wall. Maybe you’ve wondered, quietly, whether you are simply made differently from everyone else.
Let me reassure you straight away: you are not. This is one of the most common ways women first meet vaginismus.
What’s actually happening
When you try to insert a tampon, the muscles of the pelvic floor — the ring of muscle around the vaginal opening — tighten involuntarily. You don’t decide to do it; it happens on its own, often before you’ve even touched the skin. The body reads “something is about to go in” as “something to guard against,” and it closes the door to protect you.
That is the whole of it. Not a deformity, not damage, not a vagina that is “too small.” A protective reflex doing its job a little too well. And because it is a reflex — a learned response — it can gently be taught a new one.
It’s worth ruling out other things too
Tampon trouble usually points to this muscle reflex, but not always. Sometimes pain or difficulty has another cause worth checking with an informed clinician:
- An infection, such as thrush
- Skin conditions like lichen sclerosus
- Hormonal changes after childbirth or around menopause
- Pain at the entrance, sometimes called vestibulodynia
A gentle, knowledgeable examination can tell these apart — and if the idea of that examination feels impossible right now, that in itself is a familiar part of the picture, and there are kinder ways in.
Where to begin
You don’t have to force anything, and you certainly don’t have to start with a tampon. The body relearns safety the same way it learned fear — slowly, in small, repeated steps that never tip you into panic. That is exactly what gentle dilator work is for: not to “push through,” but to show the muscle, a little at a time, that nothing bad is coming.
Gentle next steps
When you’re ready, two quiet ways to begin
Understanding is the first step. The rest comes from gentle, steady practice — at your own pace, in private, with a companion by your side.
The Vaginismus Book
A gentle, science-based guide to understanding what’s happening and why. “Knowledge removes fear.” In English and German.
The TVZ App
Your private, step-by-step dilator companion. Follow a gentle 9-stage path, log each practice, and build confidence at your own pace. Everything stays on your phone.
Whatever you choose, please be gentle with yourself — your body is not failing you.
Warmly,
Dr Julia Reeve
Gynaecologist · Psychotherapist · Sexologist · Author of The Vaginismus Book
Dr Julia Reeve
Gynaecologist, psychotherapist and sexologist based in Amsterdam, with over thirty years working with women experiencing vaginismus. Author of The Vaginismus Book and creator of the TVZ dilator companion app.
This article is for general information and education. It is not a substitute for individual medical advice. If you have persistent pain or distress, please see a qualified healthcare professional.