Many people with vaginas experience difficulty during sex, especially when it comes to penetration. What used to be called “vaginismus” (a condition where the vaginal muscles involuntarily tighten and prevent penetration) is now more accurately described as:
Genito-Pelvic Pain/Penetration Disorder, or GPPPD.

What is GPPPD?

This is a condition that involves pain or difficulty related to vaginal penetration, and it can show up in different ways:

  • Pain in the pelvic or vaginal area during penetration or even just the attempt
  • Involuntary tightening of the pelvic floor muscles when penetration is attempted
  • Intense anxiety or fear of pain related to vaginal penetration

According to medical guidelines, a diagnosis of GPPPD is made when at least one of these symptoms has been present for at least six months and causes emotional or physical distress.

What causes it?

There isn’t just one cause. In fact, it’s often a combination of different factors:

  • Physical causes (such as infections, endometriosis, muscle or nerve problems)
  • Psychological or emotional causes (anxiety, past trauma, negative experiences)
  • Relational or cultural causes (fear of sex, relationship stress, social pressure)

Each case is unique. That’s why getting a full and compassionate evaluation is so important.

How common is it?

Because of stigma and discomfort in talking about sex, many people don’t seek help. But it’s estimated that up to 15% of people with vaginas may experience this condition at some point in their lives.

What can you do?

The most important thing to know is: this condition is treatable. It may take time and the support of trained professionals, but recovery is absolutely possible.

Your first step should be to speak with a healthcare provider—a gynecologist, sex therapist, or pelvic health specialist. They can help identify whether the issue is physical, psychological, or a mix of both.

Treatment might include:

  • Pelvic floor physical therapy using guided exercises and vaginal dilators
  • Sex therapy or psychological counseling, to address fear, trauma, or anxiety
  • Couples therapy, when needed, to improve communication and support

What about my relationship?

When sex becomes difficult or painful, it can affect a relationship—but it doesn’t have to damage it. Here are some important things to remember:

  • It’s not your fault, and it’s not your partner’s either
  • Honest, compassionate communication can make your bond even stronger
  • Sex is about so much more than just penetration—there are many ways to experience intimacy and pleasure

While you’re going through treatment, this can be a chance to reconnect with your body and explore other forms of intimacy: kissing, touching, oral stimulation, manual or anal play, or using sex toys if you wish.

Asking for help is a sign of strength

Living with sexual pain or fear isn’t something you have to accept.
You are not alone. And you are not broken.
With the right care and support, you can reclaim a pleasurable, confident, and empowered relationship with your body and sexuality.