Vaginismus is often described as “pain with penetration,” but that definition misses the bigger picture. In this episode, couples and sex therapist Dr. Rebecca Howard Eudy and pelvic floor physical therapist Dr. Alexandra DiGrado unpack what vaginismus really is, why it happens, and how it affects far more than just sex.

Together, they explore the role of the nervous system, pelvic floor muscles, fear-avoidance patterns, and past experiences—and why advice like “just relax” can actually make things worse. This conversation offers clarity, compassion, and an evidence-based path forward for anyone navigating pelvic pain or supporting someone who is.

What You’ll Learn:

• Why vaginismus is a protective nervous system response—not a psychological failure or conscious choice
• How the fear–tension–pain cycle develops and reinforces ongoing pain
• Why vaginismus can affect more than penetration, including exams, tampon use, sitting, and bowel function
• What effective treatment actually looks like, including pelvic floor PT, education, and nervous system regulation
• How healing focuses on safety, choice, and gradual progress—not pushing through pain

Tune in if you’ve ever thought:

• “Everyone keeps telling me to relax, but I literally don’t know how.”
• “Can this ever get better, or will it always hurt like this?”
• “How do I explain this to my partner, and what does it mean for our relationship long-term?”
• “I feel embarrassed talking about this — am I the only one?”
• “How do I get help without forcing myself through more pain?”

Helpful Resources

• Intimate Rose anal/vaginal dilators (use code ALEXANDRA1 for 20% off - affiliate link)
• The Postpartum Essentials Virtual course
• Sex After Baby Mini-Course
• Find a pelvic floor PT near you: pelvicrehab.com or Pelvic Global Directory
• Under the Hood Newsletter (Boston Pelvic PT)
• Parents in Love Newsletter by Dr. Rebecca Howard Eudy
• Parents in Love: A Guide to Great Sex After Kids by Dr. Rebecca Howard Eudy

Connect with us:

Dr. Rebecca Howard Eudy

• Website: https://www.rebeccaeudy.com
• Instagram: https://www.instagram.com/rebeccahowardeudy/
• Newsletter: https://substack.com/@parentsinlove

Dr. Alexandra DiGrado

• Website: https://www.bostonpelvicpt.com
• Instagram: https://www.instagram.com/bostonpelvicpt/
• Newsletter: https://bostonpelvicpt.myflodesk.com/underthehood

Podcast

• Instagram: https://www.instagram.com/underthehooddocs/
• Website: http://www.underthehoodpod.com