“My gynaecologist says my vaginismus is just stress” — what never gets said

Another false answer

And at some point, she says: “It’s stress. Relax. It will pass.”

Or worse: “It’s psychological. You need to see a therapist.”

You leave frustrated. Because you KNOW it is more than that. You have tried to relax. And nothing has changed.

The truth? Your gynaecologist is not wrong — and she is not entirely right either.

The 3 real causes of vaginismus (beyond your gynaecologist’s “stress”)

Before telling you “it’s stress”, your gynaecologist should identify which of these three causes is involved. Spoiler: it changes EVERYTHING.

1. Postural vaginismus (15–20% of cases)

This is a chronic contraction of the muscles of the pelvis and the rest of the body — not a matter of mental stress.

Characteristics:

• You are tense everywhere (neck, shoulders, lower back, buttocks)
• Mental relaxation exercises change nothing
• Some positions hurt, others less so
• A physiotherapist has commented on your posture or pelvis
• You have a scar after childbirth or a pelvic imbalance

Why “relax” does not work: it is not in your head. It is in your muscles. You cannot think your pelvis into relaxing — you need physical rehabilitation.

2. Emotional vaginismus (30–40% of cases)

This is fear, apprehension or a blocking belief — not generic stress.

Characteristics:

• You make progress with dilators when alone
• As soon as a partner or something at stake is involved, everything closes
• You have a conscious fear: pain, shame, guilt, expectations of performance
• It is like a switch turning off

Why “just stress” is reductive: it is not “stress”, but a specific fear. And it does not disappear through breathing — it needs emotional treatment.

3. Traumatic vaginismus (30–40% of cases)

This involves sexual trauma in which your nervous system remains permanently on alert.

Characteristics:

• You have experienced rape, assault, violence or incest
• Your reaction is intense and involuntary, even when you rationally know it is safe
• Relaxation techniques change nothing
• Your body consistently closes; it is a protective reflex

Why “it’s stress” completely misses the problem: trauma is not stress. It is the nervous system having recorded “intimacy means danger”. No amount of breathing changes that.

Table: stress versus your 3 real causes of vaginismus

Why your gynaecologist says “it’s stress” — and what she conceals

The real reasons behind this easy explanation

Reason 1: she does not have time to diagnose Distinguishing a postural contraction from an emotional fear takes time. A gynaecological consultation lasts 15–20 minutes. There is no time to explore deeply.

Reason 2: she does not have the training Gynaecologists are not trained to distinguish the causes of vaginismus. To her, it is a gynaecological symptom — so she thinks “stress” by default.

Reason 3: it is true for some of her patients In around 30–40% of cases, yes, it is linked to anxiety. So she generalises.

The result: you remain stuck. You see a therapist who helps a little (or not), because perhaps that was not your main problem.

How to identify your REAL cause (and why it is crucial)

If it is postural, you have noticed:

• Even on holiday, completely relaxed, nothing changes
• You are tense throughout your body, not just in your vagina
• Some postures make it much worse
• You make a little progress with dilators, then everything closes again once you move
• A physiotherapist has identified tension in your pelvis, buttocks or lower back

→ You need: specialist pelvic floor physiotherapy, osteopathy and postural work

If it is emotional, you have noticed:

• You make progress with dilators when alone, without pressure
• As soon as your partner arrives, or you put pressure on yourself, it closes
• You have a conscious fear: pain, shame, guilt
• It is like a psychological switch turning off automatically

→ You need: emotional work (EFT, heart coherence breathing, sex therapy)

If it is traumatic, you have noticed:

• You have a history of rape, assault or violence
• Your reaction goes beyond logic — even knowing it is safe now, your body says “no”
• Relaxation techniques change nothing
• Your nervous system remains on alert

→ You need: trauma treatment (EMDR, hypnosis, trauma therapy)

Your gynaecologist: “It’s stress” — but what kind of stress?

The real distinction your gynaecologist does not explain:

Emotional stress: rational fear, apprehension, expectations of performance. It is conscious and can sometimes be managed through breathing.

Postural stress: it is not in your head. It is chronic muscular patterns. Breathing changes nothing.

Traumatic stress: it is not stress. It is a protective reaction of the nervous system. No relaxation technique resolves it.

When your gynaecologist says “it’s stress”, she means: “I don’t know what it is, so I’m calling it stress”. But she does not tell you WHICH of the three — or whether all three are involved.

Why “just relaxing” is not enough

You have probably already tried:

• ✅ Yoga
• ✅ Meditation
• ✅ A proper holiday
• ✅ Deep breathing
• ❌ Nothing changed

You were right to feel frustrated. It probably was not “just stress”.

If it was postural: relaxing mentally changes nothing in chronic muscular patterns. You need physiotherapy.

If it was trauma: your nervous system recorded danger at a much deeper level than “positive thinking”. You need to treat the trauma itself.

If it was emotional fear: yes, relaxation can help — but only if you also address the blocking belief that creates the fear.

Stress is a symptom, not a cause. It is your body shouting “watch out, something is wrong”. Saying “relax” is switching off the alarm without looking for the fire.

Solutions — according to the real cause

For postural vaginismus:

1. Identify tension: specialist pelvic floor physiotherapy
2. Work on patterns: regular postural exercises
3. Add osteopathy: to release restrictions in the pelvis
4. Yes, dilators can help — BUT combined with postural work

Not: mental relaxation alone. It is not enough.

For emotional vaginismus:

1. Identify the fear: brief therapy, sex therapy
2. Address the belief: EFT, heart coherence breathing
3. Become familiar again gradually: without forcing, by creating safety
4. Dilators can help progressively

Not: “just stress, it will pass”. You need active emotional support.

For traumatic vaginismus:

1. Treat the trauma first: EMDR, hypnosis, trauma therapy
2. Regulate the nervous system: specialist work
3. Then gradually become familiar again when it is safe
4. Dilators come LAST, not first

Not: dilators alone. That is counterproductive.

What really changes things

When your gynaecologist says “it’s stress”, she is avoiding the issue. Because she does not know how to distinguish the causes.

What really changes things is understanding your actual cause.

Not “it’s stress”, but:

• “It is a postural contraction” → physiotherapy
• “It is an emotional fear” → emotional work
• “It is trauma” → treat the trauma

And once you know, the way becomes clear. It no longer goes through “relax and it will get better”.

Understand your real causes in my book Votre Vaginisme : fini l’errance, dénouer le plaisir selon votre profil — you will become more independent.

And if you do not want to remain alone with this, or would like more personalised support, consultations are available.

📖 Going further — Scarlett Kaplan’s book, Votre Vaginisme: the most comprehensive French-language reference on vaginismus.

On the same subject

• Vaginismus and pain: how I work
• An overactive pelvic floor: seven signs
• Bodily trauma and vaginismus