Sex – between two consenting adults – should be enjoyed. However, some people are unable to enjoy sex due to pain or discomfort. This may happen for different reasons. For women, some of these reasons may be as simple as insufficient lubrication. Some others may involve anatomical structural abnormalities, while in some instances, it may have psychological origins.
The number of women who experience pain during intercourse is unknown because the symptoms vary. The medical definition of pain during intercourse (dyspareunia) is pain or discomfort in a woman’s labial, vaginal, or pelvic areas during or immediately following sexual intercourse. Pain may be experienced as deep pain, sharp pain, or a burning sensation. It also doesn’t help much that both doctors and women fail to freely discuss sexual practices.
Pain beyond the first time?
It is perfectly normal for women to experience pain during their first episode of vaginal sexual intercourse. However, if pain continues to occur during subsequent sessions, or if pain during intercourse starts suddenly, then it may be necessary to investigate for possible causes.
In many cases, a woman can experience painful sex if there is not enough vaginal lubrication. In such instance, a simple solution might be to increase the amount of foreplay or use a sexual lubricant.
When a woman has vaginismus, her vagina’s muscles squeeze or spasm when something is entering it, like a tampon or a penis. The feeling may range from mild discomfort to intense pain.
The pain happens only with penetration. It usually goes away after withdrawal, but not always.
Women with this condition have described the pain as a tearing sensation or a feeling like the man is “hitting a wall.” Many women who have vaginismus also feel discomfort when inserting a tampon or during pelvic instrumentation such as a speculum examination of pap smear test.
Some women have vaginismus in all situations and with any object. Others have it only in certain circumstances, like with one partner but not others, or only with sexual intercourse but not with tampons or during medical exams.
Unfortunately, vaginismus is one of those conditions that even doctors can’t tell the cause. Some doctors have linked it to anxiety and fear of having sex. So, there may be a psychological component to it as well. But it’s unclear which came first, the vaginismus or the anxiety.
Other Sources of Pain During Sex
Conditions such as pelvic inflammatory disease (PID),
endometriosis, fibroids growing near your vagina or cervix
irritable bowel syndrome (IBS) and constipation can also cause painful intercourse. It is important to see a doctor to determine the underlying cause of pain during sex.
Women with vaginismus can do pelvic floor control exercises, in the privacy of their own home, to learn to control and relax the muscles around the vagina. One example of this is kegel exercises. Kegels are done by squeezing the same muscles you use to stop the flow of urine when urinating. Squeezing these muscles, holding them and relaxing them. You can do this many times throughout the day.
Dilation training is another approach. It is a type of progressive desensitization. The idea is to get comfortable with insertion using a vaginal dilator set. This contains a set of dilators in different sizes. Involuntary muscle reactions are what produce the tightness and pain of vaginismus. The focus of proper dilator use is in retraining the pelvic floor, not on stretching the vaginal opening.
Vaginsimus has been known to have been greatly improved by Pelvic floor control exercises and dilation training.
For women whose vaginismus is related to fear or anxiety, working with a therapist may also help. Women can learn pain elimination techniques, transition steps, and exercises designed to help them identify, express and resolve any contributing emotional components.
Vaginismus can be a very frustrating condition to have, but with patience, the right treatment and a patient and supportive partner, women with this condition can eventually go on to have pleasurable, pain-free sexual relations.