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Penetrative sex should not be painful: causes and solutions for painful penetration

Written by: Dr Anusha Dias
Edited by: Emily Lawrenson

Dr Anusha Dias is an expert in sexual & reproductive healthcare & psychosexual medicine. She provides comprehensive care and treatment for women with sexual difficulties resulting in infertility. Here, Dr Dias talks about vaginisimus, a common problem affecting women’s psychosexual health.

Penetrative sex should not be painful. If it is, then your experience may be due to a common condition called vaginismus.

Vaginismus affects a woman’s ability to engage in vaginal penetration and sexual intercourse, as it happens when the muscles around the vagina tighten involuntarily whenever penetrative sex is attempted. This can lead to emotional distress, relationship difficulties, and it can prevent you from being able to start a family. Vaginismus is a sensitive and difficult subject to talk about, so many women often suffer in silence, sometimes for years, feeling ashamed of what is happening to them. The reaction is unconscious, and it can be incredibly frustrating for those with the condition.

What are the causes of vaginismus?

There is not one sole cause of vaginismus – it depends on the individual. Worries that sex will be painful, a first sexual experience that was painful, injury to the vagina during childbirth, previous sexual abuse, and painful genital conditions like vulvodynia (chronic pain with no specific cause) can all be causes.

What are its symptoms?

Symptoms vary from person to person, and the symptoms sometimes depend on the causes of the vaginismus. Some women find that:

  • they cannot have penetrative sex at all
  • penetration is possible but painful
  • they cannot tolerate any internal gynaecological examination
  • they have an intense fear that prevents any attempts at penetrative sex

What can I do to help relieve symptoms?

1. See your GP. Seek medical advice from your GP as soon as possible. They will refer you to a specialist in Psychosexual Medicine who will encourage you to explore your feelings and fears.

2. Vaginal trainers. Your doctor might prescribe you vaginal trainers to help re-train the vaginal muscles to stop them from automatically contracting.

3. Pelvic floor exercises. They may help to gain awareness and control over the muscles that involuntarily contract.

4. Active relaxation.This is a technique which helps you to get rid of the unwanted tension you feel in your body. When you are stressed, the muscles in your body feel more tension. Certain techniques and movements can help to relieve tension and therefore reduce feelings of anxiety. 

Dr Anusha Dias

By Dr Anusha Dias
Obstetrics & gynaecology

Dr Anusha Dias is a consultant in sexual and reproductive healthcare and psychosexual medicine. She is the lead for psychosexual medicine at London North West University Health Care NHS Trust and also practices at the Clementine Churchill Hospital. She is an empathetic doctor with extensive expertise in two areas. One is in psychosexual medicine which includes psychological issues in obstetrics and gynaecology, such as pain with sex, and she provides comprehensive integrated care for women with sexual difficulties resulting in infertility including vaginismus and non-consummation. Her other area of expertise is non-operative gynaecology and she is an expert in all methods of contraception including insertion of IUDs/IUS, implants, gynaecological screening, HPV vaccine and vaginal discharge.

Dr Dias has a particular interest in undergraduate and postgraduate education and runs nationally recognised courses for the Faculty of Sexual and Reproductive Healthcare and is a regional training advisor. She has published extensively and lectures widely. She is on the advisory board of Sexplain, a not-for-profit organisation that provides educational workshops for young people.

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