What do you do when sex hurts?

Last week on Wifey Wednesday I wrote about what to do when sex is just ho hum. I received some comments asking about what to do when sex just plain hurts, and I thought it was time for a Wifey Wednesday on vaginismus, the condition when the vagina tenses up and makes sex very painful.

Here’s a heartbreaking email that I received recently from a reader:

For the first 4 months of our marriage my husband and I weren’t even able to have sex, not because of the pain but because he literally could NOT get in. I used dilators and now we can finally “get in”, but it’s still extremely painful and difficult, not romantic or spontaneous at all. It would also be great if you wrote about those of us whose husbands aren’t obsessed with sex like most men. Just last night my husband told me that he doesn’t really like sex as much as he thought he would before we were married. After spending 3 months painfully forcing silicon dilators into my body so that I could fulfill my husband’s sexual needs, having him say he doesn’t like it that much broke my heart. He said it’s not that he doesn’t find me sexy, he just feels like sex isn’t all it’s cracked up to be. It makes me feel inadequate and unappealing. I know I shouldn’t feel that way, but everyone always says that all men are sex maniacs, so if my husband doesn’t care for sex it must be because I’m not good at it. You’re always telling us wives to have sex with our husbands to make them happy, but what about when they don’t even want it?

That’s so sad, and I just want to reassure this woman that she is not alone. And there is nothing wrong with her! She just has vaginismus, a medical condition that makes sex hurt that she did not cause.

As for her husband, likely the reason that he doesn’t want sex as much is because sex really is more than just physical–it’s also extremely emotionally intimate. When he feels as if you aren’t enjoying it, it’s hard for him to enjoy it, too. In a way, you both are suffering from vaginismus, and in time, once this gets better, you’ll likely find that he desires you in a whole new way!

So let’s get to the root of the problem: sex hurts for you–and that’s affecting your relationship.

What is Vaginismus?

For those who are tormented by it, it’s horrible indeed. Many of these women can’t insert tampons or handle pelvic exams at the doctor’s office, either. One respondent to the survey I put together for my book, The Good Girl’s Guide to Great Sex, who is 29 and married for eight years, says “vaginismus put an end to sex years ago.” Today she and her husband make love less than once a month.

Before you start panicking, let me assure you that most women who experience pain when they make love don’t actually have vaginismus. It’s simply that they’re a little nervous, and so a little bit more tense than they usually would be.

The medical condition of vaginismus, on the other hand, is caused when the muscles at the top 1 ½ inches of the vagina tense up (or the bottom, depending on how you look at it—it’s really just the 1 ½ inches closest to the opening). If you’ve used a tampon, you’ve probably encountered these muscles without realizing it, because once you get the tampon passed that first inch and a half, it glides in much more easily.

These muscles tense involuntarily; you’re not tensing up during sex on purpose. Reassure yourself and your husband that if you’re having this problem, it certainly is not deliberate! In fact, it’s rather difficult to get those muscles to un-tense. But you can!

Causes of Vaginismus

The best route to a cure is to identify the underlying reason for this condition. For some, vaginismus is caused by a childhood trauma, like sexual abuse. For others, it’s a relationship issue: you just don’t feel safe and able to relax. If you take things slowly and work on why you don’t feel safe, and talk to counselors or mentors if any past abuse issues are a factor, you’ll likely find that the pain will subside as your heart is healed.

Unfortunately, for many the causes just aren’t clear. Even worse, there isn’t very much a physician can do. But that doesn’t mean it’s hopeless. What you can try to do is to train yourself to control those muscles, and thus learn to relax them. Here’s how:

How to Overcome Vaginismus

The vagina is a muscle just like any other muscle, and it can do two counterproductive things: It can completely loosen and become almost “flabby” (often after you give birth a number of times and find you’re now too loose), or it can do the opposite and go into spasm. Thankfully, there’s now help so you can learn how to control those muscles!

Read up about vaginismus

The book Sex Without Pain focuses on women who experience pain for a variety of reasons–and helps them learn how to get those muscles to cooperate. Written by an occupational therapist, she gives very concrete exercises that usually do help you see results.

Here’s one example of what you can do to identify those muscles: When you’re peeing, try to stop the flow of urine. Feel those muscles? They’re the pelvic floor muscles, the same ones that tense up when you have pain. Everytime you pee, try to tense and relax, tense and relax, three or four times so that your body learns how to relax.

Learn to exercise the pelvic floor muscles

Other physiotherapists have even created specially designed Kegel exercise weights to help you learn how to control those muscles. I know that sounds scary–but it really can work! Most treatment programs also suggest using a progressive set of vaginal dilators that you insert, starting with the smallest, until you can get them in comfortably.

Learn to stretch yourself–slowly!

I know “vaginal dilators” sounds absolutely horrible and clinical, but it’s just another way of saying “putting increasingly larger things in there”, building up to something which is about the thickness of an erect penis.

There’s a complete vaginismus treatment kit with such dilators here, or you can just purchase a set of dilators separately, and use them along with the book Sex Without Pain. Once you’re used to the dilators, you can use this as part of your foreplay, too, and see if you can handle narrow things, building up to thicker things!

How does this help you with sex?

Once you’ve mastered the dilators and you’ve been able to use the exercise weights to build up those muscles and control them, then when you start to make love, have him enter you just a little way until it starts to hurt, and try the same thing: tense first, and then relax. You may have to spend a few minutes doing this (try to treat it like a game, and for him it will probably feel nice, anyway, because you’re squeezing him), and eventually you’ll likely find that it doesn’t hurt as much.

Believe me–this honestly can work!

When I was first married I had vaginimus and sex was excrutiating.

For me, I think the root was trust issues, but I didn’t know that at the time (and I’m not honestly sure it would have made much of a difference if I did). But I was sad, frustrated, and really desperate.

I ended up seeing a doctor, but he made everything so clinical I felt almost violated. He didn’t do anything inappropriate at all, but just having to sit there, while I was naked from the waist down, as he tried to explain my anatomy and everything that should happen was just embarrassing.

I did get a hold of a set of dilators eventually, and used them on my own. Back then they didn’t have good books or the weights that you could use on your own. And I do think that when you have this problem, being able to read about it and deal with it in the privacy of your own home is sometimes better, unless you have an awesome doctor you can talk to! It’s not like there’s surgery or anything they can really do (that’s an extreme treatment). But on your own, with the right tools and lots of practice, you can learn to control those muscles and feel less panicky and less inadequate. It can even be empowering!

Pay Attention to Your Body

If sex is painful we often want to block that out, and so we prefer not to think much about our bodies below our necks. But that’s a bad idea! You can’t learn to relax if you don’t concentrate on your muscles–all of your muscles. And you can’t feel like a sexual being if you ignore your body.

So spend some time everyday just caring for your body. Do stretches for 15 minutes a day. This isn’t a sexual thing, but it helps you pay attention to your body, and helps your body to feel wonderful! And dress your body nicely and take care of it. Don’t hate it. Embrace it, because while sex may hurt now, the route to healing will be found by learning how to make your body feel good–not by ignoring your body.

See Your Sex Life as More than Just Intercourse

When sex hurts, it’s awfully hard to look forward to. And it can make us mad: why would God create sex so that your husband wants sex to feel loved, but what makes him feel loved is something that hurts you? It all seems so unfair.

But focusing on how unfair it all is won’t help you overcome it. Instead, start telling yourself the truth about sex: I am a sexual being. It may not feel that way right now, but you are. And you were created to feel pleasure. And it is possible!

If you don’t feel pleasure from sex yet, you can feel pleasure from other things. So start thinking of your sex life as more than just intercourse. Make sure that each sexual encounter has something that will make you feel relaxed and good. Start with a bath where you’re naked together, talking. Then move on to a massage (again, naked). Let yourself feel intimate and awfully relaxed! And then learn how to make you feel good, by helping him bring you to orgasm another way. Sometimes when we have vaginismus we do the opposite: we forget foreplay altogether and just have intercourse to get it over with, and it’s empty for both of you. Instead, do the opposite. Slow things way down and learn to relax.

If you want a step-by-step guide to take you through this process, my 31 Days to Great Sex will help you talk about what you’re experiencing, help you figure out what feels good, and help you work on all aspects of your sexual relationship–not just intercourse.

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