A Melbourne mother says a diagnosis of vaginismus six months after giving birth helped explain months of pain and disconnection — and highlights what experts say is an under-recognised condition that can follow childbirth trauma.
Madeleine Edwards, 31, who lives in Naarm/Melbourne, was diagnosed with vaginismus after a painful series of complications following an episiotomy and forceps-assisted birth of her daughter, Carmine. During labour Carmine’s heart rate dropped and doctors advised either a Caesarean or an episiotomy with forceps; Edwards chose the latter. Over the next four months she needed three rounds of stitches for the episiotomy site amid continuing pain and an infection. It was only at a review appointment, months after her final operation, that clinicians told her her vagina was “very, very dry” and that she was tensing “a lot more than you should be” — a finding later confirmed by a second gynaecologist.
Vaginismus is an involuntary contraction of the muscles around the vagina that can make penetration painful or impossible, Jean Hailes associate professor and minimally invasive gynaecological surgeon Pav Nanayakkara explains. The tightening can occur during sexual intercourse, tampon use or medical exams. Nanayakkara said many patients do not come forward, and while some studies put prevalence at 1 to 6 percent, she estimates around 5 to 10 percent of people assigned female at birth will experience it at some point in their lives.
Clinicians describe two forms. Primary vaginismus occurs without a specific prior trauma, while secondary vaginismus develops after a distressing event — and childbirth is a common trigger. “The body is trying to protect you from whatever it is that was traumatic,” Nanayakkara said, noting that severe tearing, infections, a feeling of vulnerability in labour, or not feeling heard by caregivers can all contribute. Jenny Pell, a senior physiotherapist at Melbourne’s Royal Women’s Hospital, likens the condition to a muscle spasm driven by the brain perceiving threat; identifying the cause, she says, can “take the fear out of the symptoms and allow physical progress to begin.”
For Edwards the diagnosis was, at once, heavy and relieving. She described feeling scared of her own body after failed attempts at penetrative sex and avoiding touching the area altogether. “No-one in my immediate life could experience that with me and, honestly, no-one really knew what vaginismus was — me included,” she said. Being told what was happening gave her validation and a pathway to seek care.
Experts warn against “pushing through” pain. Nanayakkara and Pell both stress that trying to force intercourse or medical exams can reinforce the negative associations and worsen symptoms, making them harder to treat. Sexual health psychologist Sarah Ashton, director of SHIPS, also emphasises that because there can be a psychological element, the pain is often dismissed as “in someone’s head” — a misconception she rejects: “The pain is real,” she says, and the psychological and physical aspects both deserve attention.
Clinicians encourage people experiencing persistent pelvic pain, painful intercourse, or an inability to tolerate penetration after childbirth or other pelvic interventions to seek assessment. Early diagnosis can open the door to coordinated care — medical review, pelvic physiotherapy and psychological support — that clinicians say improves outcomes and helps break the cycle of fear and physical guarding.
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