When Love Sex Hurts

It can shatter your sex life, confidence and relationships. So, why don’t we talk about the psychologically-triggered disorder that is vaginismus?

Portrait of Tammy Strobel
It can shatter your sex life, confidence and relationships. So, why don’t we talk about the psychologically-triggered disorder that is vaginismus?
Corbis/Click Photos
Corbis/Click Photos

After you lose your virginity, the big expectation seems to be that from then on, sex will be forever mind-blowing or, at the very least, a pleasant way to pass time. But for those women who suffer from vaginismus, which is an involuntary contraction of the muscles around the vagina that impairs penetration, sex is at best, bearable, and at worst, excruciating. Often misdiagnosed or straight up just not talked about, it’s time to lift the lid on the disorder that’s causing more “ow” than “ooh”.

Why we’re embarrassed to say sex is painful

According to Linda Valins, author of When A Woman’s Body Says No to Sex, “There is a higher incidence [of vaginismus] among women between 15 and 24, representing the usual period of a woman’s life when she first attempts intercourse.” Yet, it’s highly likely you won’t have even heard of the disorder. Vaginismus causes the vagina to tighten so much that it’s often compared to hitting a brick wall when it comes to attempts between the sheets. Women experiencing this ongoing problem are often too embarrassed to seek medical advice or even discuss the problem with their closest girlfriends in quiet confi dence. According to Vaginismus. com, a common concern shared between sufferers is they all think: “It seems like I’m the only woman in the world with this problem.”

Caitlin, a 28-year-old accountant in a happy long-term relationship, was living with vaginismus for some time before knowing her condition even had a name. “A few months into my relationship with my now-fiance, I contracted thrush from a new contraceptive pill I had been taking,” she explains. “The symptoms of thrush caused a lot of vaginal discharge and it was really unpleasant. I had an adverse psychological reaction to these symptoms and can only explain it by saying that it made me stop seeing my vagina as sexual.” The first time Caitlin attempted having sex with her boyfriend after treating the thrush, it was so painful they had to stop. “I became incapable of seeing myself as sexy, which seemed to have a dominoeffect physically,” she explains. “Even though I was still sexually attracted to my partner, my vagina kind of shut down. Lubricants helped to allow penetration, but the sex was still painful, particularly the first few minutes of intercourse.”

The degrees of vaginismus

There are two types of this condition: primary and secondary. The former occurs when a woman has never been able to have pain-free sex in her entire life. This is often attributed to shock after experiencing a tender first time or, in the case of those who waited until marriage to have sex, anxiety caused by the heightened expectations of what sex will be like. The latter describes women like Caitlin, who once enjoyed problem-free sexual intercourse but then experienced a temporary pain-causing problem which will continue to affect them. Regardless of the category that you might find yourself in, there is little difference between the psychological and physical pain of vaginismus.

Unlike other reasons for discomfort and pain during sex – such as endometriosis, vaginal infections, fibroids or ovarian cysts – vaginismus is almost entirely psychosomatic. The pain is real and palpable, but the cause is not one-for-all. The main contributing factors can be: fear of penetration, sexual anxieties and past sexual trauma (such as abuse, or negative sexual eff ects like STIs). Just one painful or unpleasant sexual experience can trigger a fear that pain will recur next time. This can become a self-fulfilling prophecy: the fear of pain during sex is enough to cause vaginal tightening, resulting in continued pain.

It's not forever

Vaginismus is completely treatable and sufferers can go on to have rich, fulfilling and pain-free sex. However, it’s equally important to know that engaging in sexual activity need not be put on hold in the interim before you receive treatment. “We need to drive home that sex should be pleasurable but not an obligation, nor a source of pain,” says Rachel Hills, author of The Sex Myth: The Gap Between Our Fantasies And Reality. “We need to really challenge the idea that you need to have penetrative sex in order to be good at sex.”

The intertwining of physical symptoms and the psychological triggers that can cause this condition mean a number of treatment options are available, depending on the individual. Therapy will help find what triggered the disorder and guide you through how to get past this psychological block. Relaxant medications are available upon referral from your GP, which will abate feelings of anxiety before sex and can help relax vaginal muscles. Botox, although a lesser used treatment, is also an option, with injections placed at the vaginal entry to relax the muscles.

But the most recommended type of treatment is progressive desensitisation through pelvic floor or Kegel exercises. We’re sure you’re all familiar with this – simply squeeze the same muscles you use to stop the flow of urination, hold for two seconds, relax, then repeat. It’s recommended that you do 20 at a time. The control you have of your pelvic-floor muscles works just as much for relaxing them as tightening them.

For Caitlin, who chose the therapy route, her road to recovery is still a work in progress. “I’ve at least established the source of my vaginismus, and so have been able to work on how to counteract it in my mind and my body,” she says. “My boyfriend understands; we’ve been working through this for years and we’re still together. While I still need lubricant occasionally, I don't feel there is something wrong or unsexy about me because I've experienced vaginismus.”

If you’ve gone through something similar, you’re not alone. Seek help, speak up and say hello to a happier, sexier, confident you.


The Symptoms

+Pain during or in attempt of penetration, and feeling like your partner has “hit a wall”.

+Pain while inserting a tampon or any other object into the vagina.

+Pain that occurs only during penetration, and which dissipates after withdrawal.

+Anxiety or fear at the thought of penetration and an expectation that sex will be painful.

+Avoidance of sex due to pain.