Vaginismus And Sexual Pain

Author: Dr. Robert W. Birch Ph.D. © 2001

Sexologist & Adult Sexuality Educator

Used With Author(s) Permission


Sex is not supposed to hurt, but for many women it does. There are many medical reasons for painful intercourse, and a physician should always be consulted. Pain might occur around the lips and clitoris, right around the vaginal opening, or deep within the vagina or abdomen. The pain might be a burning sensation, a sharp pain, or a dull ache. Women should be willing to talk with their doctors in detail, describing the location of the pain, the nature of the pain, and the activities that trigger the discomfort.

There are some women who, even though aroused, do not lubricate will. This might be because of age or medications being taken... or just something about the woman's biology. If this is all it is, this is easily solved with the use of a good, safe, water-soluble lubricant such as ASTROGLIDE. There is an article on this site that address the use of artificial lubrication.

There can also be discomfort during intercourse if a partner's penis is too long or too thick. This can be a real concern for some couples. If the problem is one of length and the woman feels discomfort when something internal is bumped, it might help if after being entered she closes her legs. This prevents deep penetration and might help avoid that particular kind of pain. The problem of girth or thickness is not so easily solved. With time and learning to relax, this might eventually resolve itself.

There are some women who feel discomfort with attempted penetration of even the smallest penis, finger or tampon. This might be the result of a condition known as Vaginismus. Vaginismus is the involuntary contraction of the muscles that surround the vaginal opening. The tightness prevents entry and the resulting pain causes the muscles to contract even more. The woman feels out of control of this and is unaware of the involuntary tightening at the opening of her vagina. Sometimes the harder she or her partner tries, the worse it gets.

Well over 85 percent of women treated for vaginismus will be having pain-free intercourse within six months of beginning treatment. The problem is best treated by a qualified sex therapist who will give the woman relaxation exercises to do at home. As the woman learns to relax her body in general and especially her troublesome pelvic floor muscles, the therapist will introduce her to homework using vaginal dilators. These dilators come in a graduated series of sizes. A woman works her way up from a dilator perhaps no thicker than a piece of chalk to a dilator approximating the size of her partner's erection.

Much of what a woman needs to learn about relaxing and being comfortble with vaginal containment can be learned alone. However, if the woman is in a relationship, her partner will most likely be involved early in the treatment so that he understands what the purpose of the homework. He will be most certainly be involved later in the therapy as the couple approach the point when it is time to insert his penis.

A free brochure is available on the topic of vaginismus, but remember, this condition is best treated by a qualified sex therapist.


Learn about the video TREATING VAGINISMUS, hosted by internationally recognized sex therapist Joseph LoPiccolo, Ph.D.

Learn about PRIVATE PAIN, a book on understanding and overcoming Vaginismus and sexual pain by Ditza Katz, PT, Ph.D. and Ross Lynn Tabisel, CSW, Ph.D.

Learn about the video VAGINISMUS, a documentary on the revolutionary treatment of Vaginismus and Sexual Pain by Ditza Katz, PT, Ph.D. and Ross Lynn Tabisel, CSW, Ph.D.




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