Tips for Having Sex with Vaginismus (or When Penetration is just Painful)

Sex can be awkward, unexpected, or clumsy, but it shouldn’t be painful. But for some people, even when they’re enthusiastic and excited about penetrative sex, actually having it feels painful or much more difficult than it should be. If this sounds like you, or you’ve struggled in the past with using tampons or penetrative toys while masturbating, it may be related to vaginismus. It’s a condition that can cause muscle spasms or contractions that make sex difficult or painful, and it can be frustrating — but it doesn’t mean you can’t have a fulfilling sex life.
Understand vaginismus and related conditions

How do you know if you have vaginismus? Conditions related to vulvas and/or women’s health are often underresearched and not well known; you may have been experiencing vaginismus or something similar without realizing it. Vaginismus is a condition characterized by involuntary muscle contractions or spasms of the pelvic floor muscles, specifically the muscles around the vagina. These contractions can make penetration difficult or impossible, as they can occur in response to attempted vaginal penetration.
Signs and symptoms of vaginismus may include:
• Pain during penetration: One of the most common and noticeable symptoms is pain or discomfort when attempting vaginal penetration, such as during sex, gynecological exams, or the insertion of tampons
• Involuntary muscle contractions: The muscles around the vaginal opening may tighten involuntarily, making it challenging or impossible to insert anything into the vagina
• Burning or stinging sensations: Some individuals with vaginismus report a burning or stinging sensation during attempted penetration
• Difficulty with gynecological exams: Vaginismus can make pelvic exams or visits to the gynecologist extremely uncomfortable or painful
• Fear or anxiety about penetration: Past history of pain or discomfort means people with vaginismus often anticipate or fear the pain associated with penetration, leading to anxiety and avoidance of sexual activity or gynecological exams. individuals with vaginismus may avoid sexual intercourse and other forms of sexual activity, which can strain intimate relationships
• Frustration or distress: Vaginismus can lead to significant emotional distress, frustration, and feelings of inadequacy or failure in the context of intimate relationships.
If this sounds like you, it’s possible that vaginismus or a related condition might be part of your health profile — it’s a good idea to speak to a professional.
Seek professional help if possible

A healthcare provider or a specialist in sexual medicine can help diagnose vaginismus — even if you’re pretty sure that’s what you have, a professional diagnosis can be the key to getting access to other treatment or referrals to specialists. A professional can also provide guidance on appropriate treatment options — for instance, a pelvic floor physical therapist can teach you exercises and techniques to release and strengthen your pelvic floor muscles. They may use biofeedback and dilators to help desensitize and relax the vaginal muscles over time.
Although it may feel unnecessary for a physiological issue, seeing a sex therapist (or a traditional therapist who’s competent at addressing issues related to sex and relationships) can be enormously helpful as well. Vaginismus can be emotionally and psychologically impactful, from the fear and anxiety associated with penetration to the more abstract stigma of feeling that something is “wrong” with you or a fear of disappointing sexual partners. A sex therapist can help address these fears and help you find a baseline of confidence and self-assurance in navigating your sex life with vaginismus.

Communicate openly with sexual partners

In order for any sexual partners to be on board with what you need during sex as someone with vaginismus or a related condition, they have to be in the loop. Talking with partners about “problems” related to sexcan feel uncomfortable or unsexy, but a good partner will be enthusiastic to understand more about you so they can be a better sexual partner.
This doesn’t have to entail giving someone your entire medical history, or even sharing a diagnosis. For casual partners, even something like “I don’t always want penetrative sex, I’ll let you know,” can be fine. For long-term partners, it’s good to help them understand not just the immediate impact of your vaginismus on the immediate sexual acts, but how living with vaginismus impacts your life broadly. Do you want more communication than their past partners might because you don’t know how you’ll be feeling on any given day? Do you feel some insecurity or anxiety about sex because of it and you need some patience around that? If you feel pain during sex, do you want to switch to another activity, or pause entirely?

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