I am a 31-year-old girl and I feel pain when I have sex with my boyfriend. When he enters my vagina, it hurts, even though I am wet enough down there. Sometimes I choose to force myself through the pain, because I want to have him inside me and have real intercourse, which sometimes arouses me enough to climax together with him. But then afterwards everything feels raw, and even peeing hurts because the urine bites into the tender skin around the vagina opening. It takes about two days for the pain to disappear. Now before I start to associate sex with pain, I want to find a solution for this problem. My friend is very considerate: when he knows I hurt he stops at once.

There are many different causes of pain during sex. Let us assume that you have seen a doctor who cannot find any sign of infection, chronic inflammation or other trouble. Then the most likely cause of your painful intercourse is something called ‘vaginismus’, in which the muscles around the vagina opening contract at the approach of an object, be it a finger, a penis, or speculum. This response is involuntary, so you can’t control it by not wanting it. Typically, like other women with vaginismus, you have forced the penetration occasionally and suffered the consequences.

Vaginismus: fear of penetration

The cause of vaginismus is fear of being penetrated. This is very natural. Most girls have it the first time, not because of a hymen (which is often non-existent) but because they contract their vaginal muscles. In some, this continues, often because they expect to have painful sex and tense their muscles involuntarily. This can easily become a vicious circle, causing them to avoid sex, even though they might have a satisfactory relationship practising oral and manual sex only. The partner is usually very careful, and does not quite know what to do. He goes along when she forces the penetration (for herself or because she wants him to feel good), but afterwards feels guilt and irritation when she complains about pain. After a while he may find he cannot have an erection with her. Couples sometimes can get stuck into this pattern for years, seeking help only when they want a child.

Vaginismus: recommendation

The first recommendation to you is to abstain from penetrative sex for some time to come (see great sex without intercourse). You and your partner must both commit yourself fully to this. You can start getting to know your own anatomy by holding a mirror and inspecting all parts, touching them, wetting them with saliva or lubricant. After having practised this a couple of times, when you feel really comfortable, you can approach your vagina with your little finger or something even narrower such as a honed down carrot. Relax by sighing deeply, then insert the object a little bit, letting it rest until you feel quite comfortable, taking it out and putting it back in a couple of times, until you are quite comfortable. If not, repeat the next day. Arousing and making yourself come while the finger is inside is a good idea, but nothing should be forced. So the principle of vaginismus therapy is that you learn to feel comfortable while your vagina is approached and penetrated by an object. Gradually, you enlarge the object: a bigger finger, two fingers. The same exercise can be done with your partner present, and also by him. Remember to relax every time the object is inside you until you feel quite comfortable, then become aroused and even have an orgasm. At last you will be able to do the same with the penis. Do it gradually, step by step. Hold the penis, learn to play with it, see it erect without being frightened or disgusted. When it goes, partly, into your vagina for the first time, leave it in for a minute, then take it out, then repeat. Thus, slowly but surely, you can practise having the penis inside you without any difficulty. Keep your vagina well-lubricated at all times. If you follow these suggestions, your vaginismus will become a thing of the past.