7 reasons why your vagina may feel too tight and what you can do about it

• A vagina that feels tight can make it painful to insert anything from a tampon to a penis.
• Childbirth, yeast infections, and STIs are common causes of a tight vagina.
• Other causes include medical conditions like vaginismus, endometriosis, and menopause.

There are many different reasons why your vagina may feel too tight, resulting in pain while inserting a tampon or during sex.

In fact, an estimated 75% of women experience pain during intercourse at some point in their lives.

Good news is that, in most cases, this kind of pain is treatable, says Kecia Gaither, MD, Director of Perinatal Services at NYC Health + Hospitals/Lincoln.

Important: "For a normal functioning vagina, there's no such thing as too tight," says Gaither. "The vagina lubricates itself and is able to stretch and accommodate babies, tampons, and male genitalia."

Here are seven reasons why your vagina may feel too tight and what to do about it.

1. Vaginismus

Vaginismus is a medical condition in which the pelvic floor muscles tighten involuntarily, usually in anticipation of vaginal penetration either during sex, before inserting a tampon, or during a pelvic exam.

Symptoms of vaginismus include:

• Sudden vaginal tightness
• A burning or stinging pain in the vagina
• Pain during sex, when inserting a tampon, or during a pelvic exam
• Muscle spasms in the vagina

Treatment for vaginismus can include a few different therapies, says Heather Jeffcoat, DPT, owner of Femina Physical Therapy. These include:

• Pelvic floor physical therapy. This involves exercises and stretches aimed at reducing tension in the pelvic floor muscles.
• Vaginal dilator therapy. The purpose of this therapy is to stretch the vagina with tube-shaped devices called vaginal dilators.
• Cognitive-behavioral therapy. This form of therapy requires meeting with a licensed therapist who can help you understand your feelings of hesitation around sex and how that affects your thoughts and behaviors. Working through these feelings with a therapist may help your body relax and reduce symptoms of vaginismus.

2. STIs

Complications from sexually transmitted infections (STIs), like chlamydia and gonorrhea, can also cause painful intercourse, Jeffcoat says.

About 1.6 million new gonococcal infections were reported in the United States in 2018. Symptoms of gonorrhea include:

• Vaginal bleeding between periods
• Pain or burning during urination
• Increased vaginal discharge

About one in 20 sexually active women ages 14 to 24 have chlamydia. Symptoms of chlamydia include:

• A burning sensation during urination
• Abnormal vaginal discharge

If you are experiencing these symptoms, or suspect you may have an STI, consult with a doctor. It's important to get treated for an STI as soon as possible to avoid pelvic inflammatory disease, which is an infection of the reproductive organs and can lead to infertility, ectopic pregnancy, and long-term abdominal pain.

You can reduce your risk of getting an STI by using a condom, and if you are sexually active, it's a good idea to get tested regularly.

3. Yeast infection

A yeast infection is a fungal infection that can cause irritation, burning, itching, dryness and swelling in the vagina, making it feel tight, Gaither says. Yeast infections are common, affecting about 3 in 4 women at some point in their lives.

But yeast infections are easily treatable with antifungal medication, which you typically take for about three to seven days. Medications are available over the counter or by prescription.

Note: Some women experience frequent yeast infections, which may require more advanced treatment over the course of months.

4. Dyspareunia

Dyspareunia is a blanket term for painful intercourse, Jeffcoat says.

Vaginismus is one type of dyspareunia. Others include:

• Vestibulodynia, which is pain at the opening of the vagina and not in the vaginal muscles like with vaginismus.
• Vulvodynia, which is chronic pain and irritation of the vulva.
• Vulvar vestibulitis, which is a type of vulvodynia that involves pain and redness surrounding the opening of the vagina.

Treatment for the various types of dyspareunia depends on the cause. In some cases, an underlying medical condition, like endometriosis or pelvic inflammatory disease, can cause dyspareunia and treatment will involve addressing that underlying condition.

Other treatment options are similar to those used to treat vaginismus, Jeffcoat says, and can include pelvic floor physical therapy or vaginal dilator therapy.

5. Childbirth

Estrogen levels decrease after childbirth, which can result in the vagina becoming thinner, dryer and less elastic (a condition called vaginal atrophy). This is especially true if you are breastfeeding, as breastfeeding can suppress estrogen levels even more.

Note: Sometimes a laceration that occurs during vaginal birth will cause some discomfort as well. This is uncommon and your health care provider will examine you and suggest treatment for this if necessary.

Vaginal dryness after childbirth is common. In a 2018 study of postpartum women, 43% reported vaginal dryness six months after giving birth.

Treatment for painful intercourse and a tight vagina after childbirth include:

• Topical estrogen creams to restore elasticity to the vagina
• Vaginal moisturizers or lubricants
• Estrogen therapy, which may include vaginal rings or tablets

6. Menopause

Menopause marks the end of a woman's reproductive years. During this time your ovaries stop producing estrogen, which stops menstruation.

Just like after childbirth, this drop in estrogen can lead to vaginal atrophy, causing the vagina to feel tight.

Other symptoms of menopause include:

• Hot flashes
• Mood swings
• Thinning hair
• Dry skin
• Night sweats
• Difficulties sleeping
• Irregular periods
• Weight gain

The symptoms of menopause can cause discomfort, but there are ways to treat and manage them. Treatment options for vaginal atrophy affiliated with menopause are similar to treatment of vaginal atrophy after childbirth, and include vaginal moisturizers, lubricants, and topical estrogen creams.

Those experiencing menopause may also benefit from hormone replacement therapy, which involves taking medication to restore your body's balance of estrogen and progesterone.

7. Cancer treatment

Estrogen-blocker therapies, commonly given to treat breast and ovarian cancers, can also cause the vagina to feel tight, Jeffcoat says. These medications include:

• Arimidex
• Aromasin
• Femara
• Evista
• Fareston
• Faslodex
• Tamoxifen

These medications reduce levels of estrogen, which can lead to vaginal dryness and tightness that can be treated with vaginal moisturizers and lubricants. Pelvic floor physical therapy may also help.

"It should be standard of care for women undergoing estrogen-blocking therapies to be given the option of pelvic floor physical therapy to preserve sexual function," Jeffcoat says.

Additionally, direct radiation to the pelvic region can result in vaginal stenosis, which is a narrowing of the vaginal canal. Using vaginal dilators is crucial to preserving vaginal canal length and diameter that may be affected by pelvic radiation, Jeffcoat says.

Can a vagina be too loose?

Just as a healthy, normally functioning vagina cannot really be too tight for intercourse, it also can't really be too loose. Although there may be circumstances in which the vagina feels loose, particularly after childbirth, Jeffcoat says.

This is because some of the pelvic muscles may have been damaged or you may have experienced tears that need to heal, Jeffcoat says. Kegel exercises, which involve tightening and releasing the vaginal muscles, can help rebuild lost strength in your pelvic floor.

Working with a pelvic floor physical therapist can also help you recover from childbirth and regain strength in your pelvic muscles, Jeffcoat says.

Pelvic floor exercises can also help to strengthen pelvic floor muscles that may weaken with age.

Insider's takeaway

There are many reasons why your vagina may feel tight, like vaginismus or vaginal atrophy as a result of menopause.

If you are experiencing painful intercourse, vaginal dryness, or pain when trying to insert a tampon, talk with your doctor.

Treatment options will depend on the cause but may include pelvic floor physical therapy, vaginal dilator therapy, hormone replacement therapy, or estrogen cream.

Complications from an STI or an underlying condition like endometriosis may also be to blame, so it's important to consult with a doctor before seeing a physical therapist to rule out infections or other medical causes, Jeffcoat says.