What are the reasons for a tight vagina?
At Proactive for Her, we don’t love using the term “tight vagina”. When people are talking about a “tight vagina”, they’re usually referring to the fact that penetration in the vagina is difficult. This can be penetration in regards to intercourse, the use of a sex toy or vibrator, inserting a tampon or menstrual cup, or even undergoing a gynecology exam! The “tight vagina” that is being referred to, can happen due to a variety of reasons, some of which aren’t often spoken about! Read on to learn more.
Vaginismus
Vaginismus is a condition where women experience an involuntary contraction or muscle spasm at their vagina in response to penetration or the thought of penetration. It’s considered a primarily psychological condition with physical symptoms. Over time, muscles in the pelvic floor including the ones surrounding the vagina can start to have tension points due to constant spasming. Women who have vaginismus often feel like they have a “tight vagina” because penetration is difficult. In actuality, it’s the combination of spasms and tension points that make the opening of the vaginal wall smaller. This doesn’t have to be permanent! It also doesn’t need surgery to resolve. Muscles surrounding your vaginal wall and pelvic floor are similar to that of muscles anywhere else in the body - if a person works on stretching, sending blood and oxygen to the area, and connecting with it, they’re able to relax and lengthen! Vaginismus is considered a psychological condition, so it’s important to address the root cause of why someone is experiencing this block in response to penetration.
At Proactive for Her, we offer a comprehensive online Vaginismus Program, which helps address the mental and physical symptoms associated with vaginismus or feelings of a “tight vagina”. We also offer in-person and online pelvic health physiotherapy sessions to help guide you on how to relax your vaginal muscles with tools such as dilators.
Infections
Vaginal or urinary infections can be a source of significant pain and discomfort. When the body experiences pain, especially around a specific area, the muscles around it begin to tense up - what we call a guarding response. When someone experiences an infection around the pelvic floor, the muscles around the vagina can start to contract and create tension, especially because the urinary tract and vaginal canal are so close together. An infection in one area causes muscles around the other openings to tighten as well.
The pelvic floor houses a lot of nerves, all of which are great at remembering. Even when the infection has cleared, the nerves still remember the pain they experienced and will often fire (causing muscles to contract) in response to even the thought of the infection or anything touching the area. Constant contraction can lead to tension and trigger points in the pelvic floor muscles. This is why people who have experienced infections around the uterus, bladder, rectum, anus, vagina, or urinary tract might feel like they have a “tight vagina”.
If you feel like you might be experiencing tension around your vagina due to a previous infection, we offer one-on-one, personalised physiotherapy care (both in-person and online) at Proactive for Her. Our physiotherapists are trained in helping your muscles relax and teach the brain how to decipher what actual danger is (another infection, harmful penetration), so it’s able to maintain a relaxed state. If you feel like it’s impossible to even penetrate your own finger due to the pain or fear of pain, set up a screening call with one of our gynecologists or physiotherapists so they can assess what’s the best suited treatment for you.
Dyspareunia
The term dyspareunia means “pain with intercourse”. Having a “tight vagina” or decreased flexibility in the pelvic floor muscles is a reason why someone might be experiencing pain with intercourse. On the other hand, an experience (or multiple experiences) of pain with intercourse is a reason why a person might experience tension around the vagina and pelvic floor muscles. Remember, the nerves around the pelvic floor and its organs act as bodyguards, protecting us from pain and any other situation we perceive as dangerous. So if someone has experienced painful intercourse in the past, the next time they attempt to have intercourse or penetrate into the vaginal opening, the nerves will send signals to the muscles telling them to tighten or close off the vagina, in order to protect it. To the person, this can feel like tightness in the vagina.
If you’re experiencing pain with intercourse or feelings of tension around your vagina when attempting intercourse, consult with one of our pelvic health physiotherapy experts who can help you address your tension and improve your experience with intercourse!
Injuries or Trauma (including Childbirth)
Injury to ANY area in the pelvis - which can include your urethra (where urine comes out), vagina, anus, rectum, uterus, bladder, large intestine, hips, low back, and tailbone, can lead to increased tension in the pelvic floor muscles. Once again, this can be interpreted as a “tight vagina”. Delivering a baby, whether vaginally or through a caesarean is considered to be an injury! Similar to how the nerves in the pelvic floor react to pain, when trauma happens, the nerves once again store the memory of the pain and negative feelings that came with the trauma. After a traumatic event or injury, a person’s mind tends to become very sensitive to anything that might be dangerous. Often, the mind starts interpreting situations, people, and objects as danger, even though they might not be. When the mind is in a constant state of “guarding” or stress, the body starts to experience an increase in tension as a result of this. A simple example is that of your upper back and neck muscles. This is a common area for people to experience tension points and pain, especially when they are stressed. Similarly, a person’s pelvic floor muscles are also known to hold tension when the mind is stressed, which can be interpreted as a “tight vagina”. This happens because the opening feels smaller due to the increased muscle tension.
If you have experienced trauma or injury anywhere around the pelvis, including your urethra, vagina, anus, rectum, uterus, bladder, hips, low back, abdomen, tailbone, or gut, and you’re feeling an increase in tension, pain, or the feeling of tightness around the area, it’s important you consult a pelvic health physiotherapist.
Menopause
During menopause, a woman’s body goes through hormonal changes, especially a decrease in estrogen. Estrogen helps the vagina stay lubricated, keep infections away, and make sure the muscles and skin around the vagina are flexible. When there is a decrease in estrogen, the vaginal canal starts to experience dryness, it’s more susceptible to infections, and the flexibility of the muscles and tissues in the pelvic floor goes down. This can make women feel like they have “tightness” in their vaginal opening, but in fact it has more to do with the mobility in muscles, not the actual size of the vaginal opening or canal. It’s important to use research backed treatment for the lack of flexibility in the vaginal tissues, which includes using topical estrogen creams and pelvic health physiotherapy.
If you’re going through perimenopause or menopause and are experiencing pain or difficulty with intercourse and penetration, it’s important you consult both your gynecologist and pelvic health physiotherapist. At Proactive for Her, we have experts in both fields who can help improve your quality of life!
Conclusion
The anxiety and shame that comes with feeling like you have a “tight vagina” can cast a strong negative shadow on your life. It’s important to start by first changing the terminology to reflect what’s actually happening in the body. There is tension and restriction in the muscles of the pelvic floor which may feel like the opening or canal of the vagina don’t have enough space for penetration. This is different from a true lack of size in the structures. Our muscles and tissues are flexible, sometimes we just need some guidance to improve flexibility. If you feel like there isn’t enough space in your vagina, you’re not sure how to relax at your vagina, or there’s some type of block when you’re attempting penetration, it’s important to seek help. At Proactive for Her, we offer one-on-one specialised pelvic health physiotherapy, as well as a Vaginismus Online Healing Program. We offer non-judgemental, evidence-based, holistic treatment focused on improving pain and quality of life.