So what I've learned is that tissue health degrades with menopause, however vaginisum required pelvic floor therapy for muscle tension and muscle spasms. My understanding is while muscles are tense, there is lack of blood flow to the tissue in and around the vulva area so that tissue is constricted and can't plump up. I invested in a book on vaginisum and a pelvic floor wand, specific for trigger pain through massage of the muscles in pelvic floor to teach them to respond differently to penetration and allow more blood flow to tissue, plumping it up. And I use a numbing agent right at opening. All takes about 3 months to get those results. Make sure when you take breathes, slow tummy inflating inhales, supposed to help lengthen the cavity as well.