Of the many psychological problems which interfere with sexual functioning, one of the most devastating and detrimental which can also have damaging effects on dating and relationships, not to mention self esteem, confidence, body image and so much more is having painful intercourse- a condition which is also known as vaginismus.
Painful intercourse or vaginismus is most typically a psychological problem with actual physical symptoms of pain, vaginal tightness, burning, or discomfort experienced by a woman when she engages in intercourse. Because the pain is real, and feels very real, many women may seek the consult of a medical doctor, hoping to find a medical solution, which may yield some results, but without addressing the emotional and mental components, and thus simply treating the physical symptoms can fall flat, and can be extremely frustrating leaving the woman to feel that there is no cure, and that she is inherently flawed.
Along with pain, the other symptom of vaginismus is fear, fear of pain which leads to a fear of intercourse.
It is hard to fathom and often believe that the mind is a powerful muscle enough to create a physical pain from a painful thought or uncomfortable belief, but vaginismus is evidence that is can, and the fact that many women have overcome vaginismus is evidence that it is possible to treat and overcome fear and pain simultaneously.
When a woman experiences vaginismus or pain during intercourse she will go into avoidance mode. She will avoid going on dates, she will avoid talking to men, even making eye contact with men because every interlude leads to the inevitable pain. In a long term relationship this can have dire effects. She will avoid her partner in most intimate scenarios, will dismiss all of her partner's advances which can lead to the partner feeling rejected, which fosters and spreads the feelings of inadequacy back and forth between partners. While feeling embarrassment, humiliation and shame because of her fear and pain which leads to an inability to share intimacy with her partner, the partners in turn often end up feeling dejected all of which have profound effects on the relationship. The woman who suffers from painful intercourse will avoid talking about sex at all. The stakes are too high. The cost is her womanhood, her health, and her happiness. A healthy sexuality is at the core of having healthy, fulfilling and successful relationships and this is something that can feel very elusive when one is suffering from vaginismus.
It is important to look at the root causes of what may be causing the painful intercourse. Some of the causes of vaginismus could include past traumas, which can be mental, physical, and/or sexual. Commonly associated with these traumas are long term belief systems which perpetuate a fear or intercourse and thereby is also associated with pain. Vaginismus is a multi-faceted condition which needs to be addressed from many fronts. The woman not only needs a safe space to uncover, explore and process the past messages, pains and fears, but also needs to expand, grow and develop interpersonal skills, relational skills and develop more knowledge about female and male sexuality to deal with present more recent and recurrent themes.
The physical pain can be addressed in many ways. If the woman has a partner already, it can be greatly beneficial to include that partner in the treatment process. Starting at the basics of the relationship such as building trust from the very bottom is the best place to start to simultaneously address fear and pain. If the woman does not have a partner, the use of dilators and numbing cream to deal with the pain, coupled with intensive psychotherapy, sex education and some form of body work to address fear and develop new coping skills is the best way to seek results.
It is important to know that painful intercourse is not necessarily a medical condition, but is better seen as a self-induced, somatic symptom, a coping skill rather which the mind developed over time as a protective mechanism to keep one safe from harm. The skill may have worked when the woman was younger, but with time and with age, the coping skills need to be revisited and revised to suit her present needs.
Most women who suffer from painful intercourse do so in part also because they do want to learn to trust and to have a healthy satisfying sex life and intimate relationship, this makes the pain that much more intolerable. The first thing a woman who is suffering from vaginismus should do is get informed. Knowledge about herself and her sexuality can go a long way and can help to open her eyes to the solution, which may already be very well within her grasp.
Moushumi Ghose is a Sex Therapist, a Licensed Marriage and Family Therapist, A Certified Hypnotherapist, Author and Love/Dating Coach. She is the host of The Sex Talk, a web series dedicated to sex education. She has made several TV and media appearances. She offers sessions via Skype.