Sex is meant to be a pleasurable and enjoyable experience for women and their partners. But did you know that many women actually associate sex with pain and fear, with many of them even having unconsummated marriages.

This problem is not uncommon, yet many women going through it feel ashamed or embarrassed to talk about it or seek help. This is particularly so in a conservative society like Singapore.

These women may feel inadequate in their marriage or relationship, which can affect their intimacy and bonding with their partners. This also leads to problems such as depression or anxiety.

What Is Happening And How Can You Get Help?

worried woman

If you are reading this and are going through a similar situation, remember that you are not alone!

Difficulty with sex is usually due to a condition called Vaginismus.

Vaginismus is a condition whereby you experience involuntary tightening of the vaginal walls.

This makes penetrative intercourse difficult or even impossible as the muscles around the vagina start to clamp up once penetration is attempted.

A common complaint is that the partner will feel as though he is “hitting a wall”.

The important thing to note is that this is a problem that CAN be solved, and there is nothing embarrassing about getting help regarding this issue.

How Do I Know If I Am Experiencing Signs Of Vaginismus?

strained relationship due to vaginismus

Here are a few signs that may suggest that you have Vaginismus:

  1. You associate the idea of sex with pain
  2. You cringe at the thought of vaginal penetration
  3. You tried to have sex but you find yourself involuntarily tightening your legs and pushing your partner away
  4. It is difficult or impossible for you to relax and be tension free during intercourse
  5. You notice that you immediately become dry down there and your arousal is stopped abruptly when your partner attempts penetration
  6. You avoid sex at all cost and find excuses to lie to you partner to get out of it
  7. You encounter similar problems of tension and pain when getting a vaginal examination by your doctor

What Causes Vaginismus And Painful Sex?

woman lying in bed

The most common cause for 80% to 90% of all women who experience vaginismus and painful sex is due to psychological reasons.

However, it is not always all in the mind!

Your symptoms may actually have a medical explanation behind it and hence it is always important to investigate your symptoms.

What Are The Other Possible Causes?

  1. Endometriosis

    endometriosis in the pelvis

    Endometriosis is a condition where parts of the endometrial lining implant itself elsewhere in the pelvis. This leads to inflammation of the surrounding tissue and can often lead to pelvic pain.

    Women with endometriosis also commonly experience painful period cramps.

    Endometriosis should be ruled out in women experiencing painful sex.

  2. Pelvic Inflammatory Disease (PID)

    pelvic inflammatory disease with adhesions

    Pelvic inflammatory disease leads to chronic inflammation of the uterus and other reproductive organs. The chronic inflammation of the tissues can lead to increased pain and sensitivity.

    Pelvic inflammatory disease is usually caused by long-standing or untreated vaginal infections such as chlamydia.

  3. Previous Pelvic Injury Or Surgery

    pelvic surgery being carried out

    A history of injury or trauma to the pelvis or previous surgery can lead to scar tissue formation. This can also lead to increased pain and sensitivity in the pelvic and vaginal region.

  4. Previous Radiation Therapy Or Chemotherapy

    radioactive sign for radiation therapy

    Painful intercourse after radiation therapy is relatively common as radiation causes scarring of the vaginal tissue and distorts the normal anatomy as well.

    This is a common challenge faced by women with a previous history of cancer who are trying to regain intimacy with their partners.

  5. Emotional Factors

    depressed woman

    One of the more important things to rule out are emotional factors such as anxiety or depression. Sometimes, the fear experienced by these women may be due to a previous traumatic experience such as sexual abuse or assault.

What Are The Treatment Options?

woman seeking help with counselling

Treatment will depend on the cause behind the symptoms.

An in depth history about your previous and current sexual history and practices will have to be taken.

Additionally, counseling by an experienced therapist or sexual psychologist can go a long way in helping you cope with and confront your fears.

Other treatment modalities can also include:

vaginal dilator set

  1. Use of dilator therapy
  2. Topical pain killers to ease the pain and discomfort
  3. Vaginal lubrication
  4. Pelvic Floor Exercises
  5. Vaginal Botox