Vanessa Cushing in the News….
In the press · Woman's World · 6 min read
Vaginismus: Why Sex Hurts, and Why Your Body Isn't Broken
Woman's World asked Vanessa Cushing what vaginismus actually feels like, what sets it off, and what changes in treatment. She answers as a certified sex therapist who treats it daily — and as someone who has had it.
Written and clinically reviewed by Vanessa Cushing, LPC, NCC, MS — AASECT-Certified Sex Therapist, licensed in Virginia, DC, Maryland & Florida.
The short answer
Vaginismus is an involuntary tightening of the pelvic floor muscles when penetration is attempted or anticipated. Vanessa Cushing told Woman's World that women often describe it as “hitting a wall, a burning or tearing sensation or the body ‘slamming shut’” — and that the turning point in treatment usually comes when a woman stops seeing her body as broken and starts seeing the tightening as a protective reflex that can be retrained.
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What Woman's World asked
Woman's World ran a piece on painful sex and vaginismus, prompted partly by the novel Thighs Wide Shut putting the condition into pop culture, and partly by how many women arrive at a diagnosis only after years of assuming the problem was them.
Vanessa Cushing, LPC, NCC, MS, AASECT-Certified Sex Therapist and founder of Cushing Counseling, was one of the clinicians asked to explain it — described in the article as a certified sex therapist who treats the psychological, relational and emotional side of vaginismus daily, and who has personally experienced it herself. That second part matters to the way she answers: none of the following is theoretical to her.
What it actually feels like
Clinical language calls it involuntary tightening of the vaginal muscles. Almost nobody describes it that way in a first session.
“Women often describe it as hitting a wall, a burning or tearing sensation or the body ‘slamming shut’,” she told Woman's World.
Those three descriptions are worth holding onto, because women who have them often do not know they add up to a recognised condition with recognised treatment. They know only that something goes wrong at the vaginal opening, that it is painful, and that their body appears to be refusing something they have consented to. Being able to name it is frequently the first relief anyone gets.
It is not always a trauma story
The assumption most women bring in — often after reading about it online — is that vaginismus means something terrible must have happened to them. Sometimes that is true. Often it is not, and being told otherwise is its own injury.
“It can be triggered by all kinds of things: a yeast infection or UTI that makes sex painful so the body ‘learned’ to guard against it, childbirth, menopause and related hormonal changes, a medical procedure or sexual trauma,” she told the magazine.
Then the part that reframes the whole condition: “It means vaginismus isn't just a trauma response. Sometimes the body's protective reflex gets switched on by something as ordinary as a UTI, and then keeps firing long after the original cause is gone.”
That is the mechanism in one sentence. A reflex that made sense at the time is still running now, after the infection cleared, the stitches healed or the procedure ended. Nothing about it is imagined, and nothing about it is a character flaw.
Treat the nervous system, not just the muscle
Vaginismus is generally treated on more than one front at once: pelvic floor physical therapy, dilators used gradually and at the woman's own pace, sometimes medication or, in specific cases, Botox to the pelvic muscles — and psychological work alongside it.
Asked about relaxation and breathing, Vanessa's addition to the article was blunt about where the leverage is: the goal is “treating the nervous system, not just the muscle.”
This is why dilators alone often stall. A dilator can stretch tissue; it cannot convince a nervous system that penetration is safe. If the fear cycle is untouched, the muscle keeps receiving the same instruction it was already following. Work the fear and the reflex together, and progress that felt impossible starts to move.
Partners are part of the treatment
Vaginismus rarely stays contained to one body. A partner who does not understand what is happening fills the gap with the worst available explanation: she is not attracted to me, she is withholding, I hurt her, I am doing something wrong. The woman, meanwhile, starts declining before the question is asked, to avoid the disappointment that follows.
“Partners are often included in sessions, because vaginismus affects the relationship too, and shame or misunderstanding on either side can make things worse,” she told Woman's World.
In practice that means sessions where a partner learns what the reflex is, what actually helps, and what to do when a session at home does not go the way it was supposed to. It also means rebuilding a sex life that does not treat penetration as the only event that counts — which relieves pressure fast, and often accelerates the physical work.
The turning point in treatment
Asked what changes for the women who get better, she pointed to a specific shift rather than a technique.
“The most common turning point is when a patient stops seeing her body as broken and starts seeing the tightening as a protective reflex that can be retrained. That reframe alone often reduces the fear that fuels the cycle,” she said.
That is not positive thinking. Fear is part of the mechanism: anticipation tightens the muscle, the tightening hurts, and the pain confirms the fear that produced it. Take genuine belief out of the “my body is broken” loop and the loop loses power, which is why the reframe is treatment rather than reassurance.
How common is it, and how long does it take?
Woman's World cites The Journal of Sexual Medicine putting vaginismus at up to seven percent of women, and BMC Public Health reporting that up to 21 percent of women experience painful intercourse at some point in life. This is not rare, and it is not a fringe complaint.
Timelines vary honestly and widely. Clinicians in the article describe some women improving meaningfully within weeks, and others needing months of consistent, gentle work — including a patient who had not had penetrative sex for twelve years and did after roughly twelve weeks of combined treatment. Nobody promises a schedule. What is reliable is the direction of travel once the right pieces are in place.
If this is describing you
A first appointment for this does not involve an exam or anything physical. It involves saying out loud what happens, when it started, and what you have already tried — often for the first time to anyone other than a search engine.
From there the plan usually pairs pelvic floor physical therapy with sex therapy, and includes your partner if you have one. If a medical cause has never been ruled out, that gets sorted too. What you should not do is keep waiting for it to sort itself out, or keep pushing through sex that hurts, which teaches the reflex it was right all along.
Frequently asked questions
What is vaginismus?
An involuntary tightening of the pelvic floor muscles when vaginal penetration is attempted or even anticipated. It is not under conscious control, and it can range from discomfort to pain severe enough that penetration feels blocked.
What does vaginismus feel like?
As Vanessa Cushing described it in Woman's World, women often describe it as hitting a wall, a burning or tearing sensation, or the body 'slamming shut'. Many also notice they start tensing before anything happens at all.
Does vaginismus mean I have been sexually traumatised?
No. Sexual trauma is one possible trigger, but so are a yeast infection or UTI that made sex painful, childbirth, menopause and hormonal change, or a medical procedure. As she put it, the protective reflex can be switched on by something as ordinary as a UTI and keep firing long after the original cause is gone.
Is vaginismus treatable?
Yes, and usually with a combination rather than one thing: pelvic floor physical therapy, gradual dilator work at your own pace, sex therapy for the fear cycle, and in some cases medication or Botox to the pelvic muscles. Timelines range from weeks to several months.
Why involve a sex therapist if the problem is a muscle?
Because fear is part of the mechanism. The goal, in her words, is treating the nervous system, not just the muscle — a dilator can stretch tissue but cannot convince a nervous system that penetration is safe.
Should my partner come to sessions?
Often yes. Vaginismus affects the relationship, and shame or misunderstanding on either side can make things worse. Partner sessions cover what the reflex is, what helps, and how to handle setbacks without either person taking them personally.
How do I start?
Book a free 15-minute consultation. Nothing physical happens in it — you describe what is going on, and we map out what treatment would involve and who else should be on the team.
Keep reading
- About Vanessa Cushing, LPC, NCC, MS — AASECT-Certified Sex Therapist, licensed in Virginia, D.C., Maryland and Florida.
- Press & Publications — Every outlet that has quoted or published her.
- Sex Therapy — How the work runs, and what it costs.
- Couples Therapy — When painful sex has become a relationship problem too.
Also on this site
Clinical resources this page draws on
- Woman's World — Painful Sex? It Could Be Vaginismus. Here's How To Treat It — The original feature, including Vanessa's full comments.
- AASECT — Find a certified sex therapist — The certifying body's directory, if you are looking outside our licensed states.
Next step
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