January 3, 2011

Q&A: I Experience Pain During Sex. How Can I Learn To Relax?

Often, women who feel that they are not able to experience vaginal penetration are given a diagnosis of vaginismus.

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Question: My partner and I have been together for a couple of years and we are both virgins. Every time he tries to enter me, it’s like my vagina closes up. What can I do to relax and not think it is going to be painful?

You are definitely not alone. Many women experience a great deal of pain and anxiety related to vaginal penetration. Some women have either experienced so much pain from attempts at penetration, or experience so much fear about penetration, that any type of vaginal penetration – whether it’s tampon use, a gynecological exam or sexual penetration by a partner’s finger, penis or a sex toy – seems impossible.

Diagnosing The Pain

Often, women who feel that they are not able to experience vaginal penetration are given a diagnosis of vaginismus. We still have a great deal to learn about this condition. For many years, vaginismus was considered to be a condition that involved the muscles around the vagina going into involuntary spasms, thus preventing penetration. However, research has been mixed on this feature of the condition, with quite a few doctors and researchers being unable to find any evidence of actual muscle spasms.

Some doctors feel that the condition is perhaps a more extreme version of a condition called vulvodynia, which refers to vulvar pain and is often treatable. It may be that some women with vulvodynia experience more pain than other women when they attempt vaginal penetration. It may also be that some women with vulvodynia are more likely to experience fear or anxiety in connection with their pain.

Vaginal Dilators

Some women find it helpful to use graduated vaginal dilators to help them learn to experience vaginal penetration. Vaginal dilators can be thought of as a set of medical dildos, if you will, with the smallest one being about the size of a pinky finger and the largest one being about the size of a larger-than-average-sized penis. Women can practice relaxing, putting lubricant on the smallest size dilator, and inserting just a bit of it while they relax, read a book, talk to their partner, or even watch television.

Over a period of days, weeks or months, women may find that they can graduate in size and slowly use larger sized dilators, one at a time. Although vaginal dilators can be purchased over the Internet, it is often most helpful to attempt these exercises with the guidance of a healthcare provider or sex therapist.

Other Treatments

Sex therapy has a long history of being used successfully to help women with vaginismus and you can find a sex therapist in your area through the Society for Sex Therapy and Research.

More recently, some healthcare providers have been using Botox as a treatment for vaginismus with preliminary results suggesting that it may be helpful for some women. Some doctors use Botox in conjunction with recommending vaginal dilator therapy.

Taking The Next Step

In any case, there are a range of treatment options that may be helpful but the first step is to check in with a healthcare provider, which is a good idea for any woman who is considering becoming sexually active with a partner.

You and your partner might also find it helpful to talk about the issue, if you don’t already, and to find ways to share intimacy and connection even if you cannot have vaginal intercourse at the moment. Couples often find it helpful to expand their definition of what they consider “sex.” You may find it pleasurable to engage in sensual massage, breast touching, oral sex, sex toy play or other types of sex play.

Learn more about sexual exploration in Because It Feels Good or For Each Other.

Next Question: Pregnancy Risk From Using Condoms And Not Ejaculating

My girlfriend and I are both virgins and she was scared that she could get pregnant and we had sex and I used a condom but I didn’t ejaculate. Now she is scared that she is pregnant. Could she be?

Read Dr. Debby Herbenick’s response.

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