Q&A: My Vagina Tightens Up And I Can’t Have Sex

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QUESTION: I have been in a relationship for 4 years and when we try to have intercourse he cannot get in because my vagina tightens up. I have tried relaxation, meditation, etc. I read that some women have this problem. Do you have any suggestions for me? I heard that some doctors insert Botox. Do you think that will help?

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painting of a girl meditating

Photo: deflam (Flickr)

Some women report that, over time, they have come to feel so anxious about intercourse that if their partner even approaches them for intercourse, they feel nauseous, vomit, or experience a panic attack.

Some women, when they try to experience vaginal penetration, find that they feel unable to accept their partner’s penis or fingers into their vagina.

Condition Not Well Understood

This is not always limited to sexual situations. Often, women who find it difficult or impossible to experience sexual penetration of their vagina also find it difficult or impossible to use a tampon or receive a pelvic examination.

Often, this condition is described as vaginismus.

Vaginismus is not well understood. For many years, it was thought that vaginismus was caused by uncontrollable muscle spasms that prevented vaginal penetration from occurring.

However, research studies have been mixed in their ability to identify any such muscular spasms or pelvic floor activities that may be interfering with penetration.

Some healthcare providers believe that other types of genital pain may be at the root of vaginismus, perhaps in addition to fears or anxieties related to vaginal penetration. Some women describe very extreme reactions to even the thought or possibility of vaginal penetration or intercourse.

Vaginal Dilators

For example, some women have told me that, over time, they have come to feel so anxious about intercourse that if their partner even approaches them for intercourse, they feel nauseous, vomit, or experience a panic attack.

Women who experience such difficulties sometimes find it helpful to use vaginal dilators by themselves as a means of teaching their vagina to accept penetration.

Vaginal dilators typically come in sets of 4 to 6. They look kind of like dildos, but they are more often used for treatment of various health conditions. Women are often advised to start with the smallest one, which is about the size of one’s little finger, and over a period of weeks or months work up to using larger sizes.

Sex therapy is also often very helpful for women with vaginismus as well as their partners – you can find a sex therapist in your area through the Society for Sex Therapy and Research.

Botox Is One Option

You also asked about Botox, which in recent years has been used by some healthcare providers with success. If you are interested in learning more about this treatment, I would recommend connecting with a healthcare provider who has experience treating women with vaginismus in this way.

Finally, there are other possible reasons for difficulty with penetration. I would recommend checking in with a gynecologist to make sure that there are no other medical conditions or anatomical reasons that may be preventing intercourse.

If you feel anxious or worried about having a gynecological exam, let your healthcare provider know so that he or she can be attentive to your concerns.

Next Question: Period Length & Pregnancy Risk

I’ve been a nervous wreck for the past couple of days. The other day, I was on day 3 of my period, and I had my boyfriend over. We have never had sex and I pride myself on that. Occasionally, though, he will stick his hands down my pants. He doesn’t finger me or anything, he just puts his hand down there. He insists he had nothing on his hands (like sperm) but then on day 5 of my period, my period ended. Normally I have a 6 or 7 day period, so could I be pregnant? What if he accidentally touched pre-cum before putting his hands in my pants? Could I be pregnant?

Read Dr. Debby Herbenick’s response.

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Dr. Debby Herbenick (M.P.H., Ph.D.)

is a sexual health educator at The Kinsey Institute, Associate Director of the Center for Sexual Health Promotion at Indiana University and author of several books including Sex Made Easy and Because It Feels Good: A Woman's Guide to Sexual Pleasure and Satisfaction.
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