When penetrative sex first became extremely painful, Anjali (name changed) convinced herself that something was fundamentally wrong with her body. "I thought that it was a very rare thing, that I am the only one going through it," the 22-year-old HR professional recalled.
Too embarrassed to talk about it and unsure where to seek help, she spent years ignoring the problem, until she finally brought it up in therapy. That’s when she learnt she had vaginismus, a condition affecting thousands of women, many of whom do not even realise it exists.
Vaginismus is an involuntary tightening or spasming of the pelvic floor muscles, said Dr Tanaya Narendra, a sexual health educator, embryologist, and Instagram influencer. She described the vagina as “becoming like a venus flytrap that shuts itself close at the thought of any penetration."
She noted that this reaction is not limited to sexual activity, and can be triggered by medical exams or even attempting to use a tampon. “It is not a choice, but a physical response to a perceived threat or anxiety, and with the right approach, it is highly treatable,” Tanaya explained.
In recent years, the way doctors understand the condition has also changed. Dr Chandrika Anand, consultant obstetrician and gynaecologist at Saraswati Gynoworld in Bengaluru, said vaginismus is now classified under Genito-Pelvic Pain/Penetration Disorder (GPPPD) in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Rather than viewing it solely as a muscle disorder, it is now recognised as involuntary pelvic floor tightening often occurring alongside fear of pain, anxiety, and difficulty with penetration. This encourages a more holistic, biopsychosocial approach to treatment.
Tanaya said that most patients with vaginismus are able to have penetrative intercourse within two months of regular treatment. “I haven’t had a single patient so far who came in with an issue of vaginismus or penetration anxiety and was not successfully able to have intercourse,” she said, adding that many have later gone on to give birth vaginally. “That is hugely encouraging and if more people knew that, they would be able to have more faith and trust in the healthcare system.”
Yet, despite being relatively common and highly treatable, many women remain unaware that the condition even has a name.
While studies estimate that 5–7% of women globally experience vaginismus, reliable population-based data from India remain scarce.
According to a 2025 study published in the Journal of Obstetrics and Gynecology of India, of 692 women seeking help for sexual dysfunction at an Indian clinic, 45.23% were diagnosed with vaginismus.
Chandrika said the true burden is likely much higher because many women assume pain during sex is ‘normal’, couples delay seeking help, and physicians do not routinely ask about sexual function. Some patients are repeatedly treated for infections without clinicians recognising that penetration itself is the underlying problem. “Women often come several months to years after marriage, and many couples come only due to infertility concerns or when they're unable to consummate the marriage,” she said.
Tanaya noted that doctors are "not really taught vaginismus in medical school". Most medical education in India is pregnancy-focused and doctors are trained to help women get pregnant or manage birth, but they often lack the skills to address female sexual dysfunction.
During Anjali’s first visit to a gynecologist, she said the doctor began an internal examination without any warning. “She was just making small talk with me and, without any prior communication, she kept inserting the clamp or her finger to check what it was. It hurt me so much.”
She also felt that the consultation was coloured by judgement, with questions about her sexual life that she felt were irrelevant to her condition. “There was certainly an undertone of judgement there,” she said, adding that such attitudes can make it hard for women to seek help for conditions already surrounded by shame and stigma.
According to a paper published in the Journal of Psychosexual Health, healthcare providers in India often fall into several common traps when managing vaginismus. These include performing unnecessary hymenectomies–surgical procedures to remove the hymen–even when the underlying issue is not anatomical, but related to involuntary muscle tightening and psychological factors.
The paper also highlights the focus on infertility treatment, with healthcare providers concentrating solely on helping couples conceive while overlooking their broader need for a healthy and fulfilling sexual life.
Chandrika said women are also treated for recurrent infections, prescribed repeated courses of antibiotics, or advised to simply "bear the pain", without healthcare providers taking a detailed sexual history or considering vaginismus as a possible diagnosis. She added that internal examinations should always be conducted with informed consent and may even be postponed if severe anxiety is likely to worsen the condition.
Misinformation surrounding female sexual health often delays diagnosis. Chandrika said many women grow up believing that pain during first-time sex is normal or are told to simply relax, while others are reassured that childbirth will eventually solve the problem. Such misconceptions can discourage women from seeking medical help and reinforce the belief that painful intercourse is something they simply have to endure.
Psychotherapist and sex educator Neha Bhat said these beliefs are rooted in broader cultural attitudes towards sex. "We live in a culture that is so sex-negative," she said, explaining that many Indian girls grow up being told that sex is something to fear rather than a source of intimacy or pleasure. Over time, the body can begin associating intimacy with danger rather than safety, reinforcing the fear and anxiety that often accompany vaginismus. She added that while sexual trauma can contribute to the condition, it can also stem from relationship experiences, anxiety, or other emotional factors, making every patient's journey different.
Several individuals described difficulties seeking treatment due to stigma, financial dependence on family members, or concerns about privacy while covered under their parents' health insurance. Shreya (name changed), a 21-year-old undergraduate student, said she feared visiting a gynaecologist in case her parents or someone else found out. "It's not just the condition that's scary, it's the explanation you would have to give at home," she said.
Finding the right care in India is often a struggle of both affordability and availability. Proper treatment requires a multidisciplinary team (MDT), including a gynecologist, a specialised pelvic floor physiotherapist, and a psychotherapist.
Chandrika explained that treatment usually combines medical, physical, and psychological care. While gynaecologists rule out underlying medical causes and explain the diagnosis, pelvic floor physiotherapists help patients learn breathing techniques, muscle relaxation, and graded vaginal dilator therapy. Psychologists or sex therapists work on anxiety, fear of penetration, and, where necessary, trauma-informed therapy. Partners are also encouraged to participate in treatment, as anxiety and avoidance within the relationship can reinforce symptoms.
"It's an expensive treatment," said Tanaya, noting that each session requires dedicated one-on-one time that many cannot afford. She added that specialised pelvic floor physiotherapists are rare in India, making it a branch that is difficult to access.
The condition can also take a heavy emotional toll. Ananya (name changed), a 26-year-old public relations professional, said vaginismus affected her relationships and self-image. “It started creating problems in the relationship,” she said.
The fear and shame surrounding sex became so overwhelming that she avoided relationships for four years and even questioned whether she was asexual. “Once I understood what was actually happening and realised how common it was, I felt so much better.”
Beyond painful intercourse, experts say vaginismus can have far-reaching psychological consequences. Chandrika said women often experience guilt, shame, anxiety, depression, and marital distress, particularly when they begin blaming themselves for relationship difficulties or delayed conception.
She added that partners also play an important role in recovery by avoiding pressure, attending consultations, and participating in therapy, helping women understand that vaginismus is a medical condition rather than a personal failure.
Tanaya noted that improving care for vaginismus requires systemic changes within the healthcare system. She said medical education should include greater emphasis on sexual health and psychosexual dysfunction, enabling healthcare providers to recognise and manage conditions like vaginismus more effectively. She also highlighted the need for interdisciplinary care, where gynaecologists, mental health professionals, and pelvic floor physiotherapists work together to provide comprehensive treatment.
For Anjali, the turning point came when she moved beyond her negative experiences with gynaecologists and focused on psychotherapy. "Treating it through therapy and processing repressed emotions of shame and guilt worked very well for me," she said.
Looking back, she wishes she had known earlier that she was not alone. Today, she hopes more women recognise that persistent pain during sex is not something they simply have to live with, but a treatable medical condition for which help is available.
This article was written by a student interning with TNM.
