With vaginismus and pain during sex, it's often a combination of causes. One cause can also reinforce the other.
Fear of the size of the penis, begin afraid it won't fit, fear of the pain.
A negative experience during an internal examination.
Fear of letting go and losing control.
Little knowledge of the functioning of the body and sex.
Negative thoughts and/or incorrect beliefs about the vagina, penis, men, sexuality, or intercourse.
A negative (traumatic) sexual experience.
Dissatisfaction with the relationship with the partner.
Physical cause: sores, irritation, infections, or scar tissue around and in the vagina opening. These can occur after giving birth, surgery, multiple bladder infections, or because of vaginal dryness (during menopause). If you continue having intercourse despite of the pain, the skin can become even more painful. This can lead to your pelvic floor muscles cramping up, which can lead to the development of vaginismus.