When Sex Hurts

For thousands of women, intercourse is physically painful. Now there's help.

By Christopher and Rachel McCluskey

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Amanda and Randy had been married almost four months. Their honeymoon was great, except for the "main event." No matter how hard they tried, it just wasn't happening. With great embarrassment Amanda finally went to her gynecologist, thinking there was something wrong with her.

Amanda's issue represents the experience of thousands of couples. Their frustration is incredible—they can't consummate their oneness, and they don't know where to turn for help. One husband put it this way: "We were virgins when we married. Four years later we were still not 'one.' It was terrible. We went to three different counselors, and they were nice but really didn't know what to do or say to us."

After running some tests, Amanda's physician informed her that she was normal, but she had vaginismus.

Vaginismus is a condition in which the muscles in the lower third of the vagina—the pubococcygeus or pc muscles—involuntarily constrict so tightly that they're unable to allow penetration, or they at least make penetration incredibly painful.

The result is that a couple is either unable to engage in intercourse at all (commonly referred to as primary vaginismus), or is able to do so only with tremendous difficulty (secondary vaginismus). As one wife battling secondary vaginismus put it, "We were able to have intercourse, but it was unbearably painful. It never seemed to get any better. About six months after we were married, we just stopped trying."

The physical, emotional, and spiritual toll this takes on a marriage can be devastating.

Studies have shown that up to 47 percent of women experience general pain during sex, and between 6 and 10 percent suffer with either primary or secondary vaginismus. Several physiological issues can be contributing factors, including vaginal yeast or bacterial infections, urinary tract infections, physical damage from childbirth, and sexually transmitted diseases. Even allergic reactions to medications, latex in condoms, lubricants, or spermicides can lead to secondary vaginismus.

But psychological factors also play a central role, whether or not there are physical problems. Fears resulting from rape or molestation, insensitive gynecological exams, negative messages about sex being dirty or wrong, or fear of pregnancy can create these involuntary spasms, even when a woman isn't fully conscious of such fears. Feelings of disgust about genitalia, or even imagined or anticipated fear because of stories from other women or scenes from a movie, can create the reaction. And certainly fear of re-experiencing pain after unsuccessful attempts at intercourse can quickly set up a self-perpetuating cycle, creating a greater likelihood of painful penetration, which creates more fear.

It's not "all in your head"

It's important to understand that this problem isn't "all in your head." This isn't merely a "mind over matter" issue. Countless women have been told—or have told themselves—that and have tried to force themselves to complete the act in spite of excruciating pain. This only exacerbates the problem. The key is to recognize that for some reason the woman has established an involuntary pattern that operates in the same way as a simple phobia (such as a fear of the dark). But the good news is that with treatment it's nearly 100 percent curable!

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Originally published in: Marriage Partnership, 2008, Summer, Page 35

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