Don’t suffer! Here’s why sex may be painful for you

Sex is supposed to give you pleasure but If you suffer from painful sex, there may be some underlying issues with your sexual health.

painful sex causes
If sex gives you pain instead of pleasure, read this! Image Courtesy: Shutterstock
Shazia Shadab Published on: 6 February 2022, 18:00 pm IST
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Have you ever had painful sex, even when you went overboard on lubricants? If you complain of feeling extremely itchy down there during sex, it’s a killjoy too. All of this displeasure, can tend to ruin everything worth loving about sex!

If you’ve been experiencing these off-putting signs, you may be suffering from Pelvic floor myalgia (muscle soreness), also known as vaginismus. It is a common cause of painful sex and results in an involuntary tightness of the pelvic floor muscles.

For many women, the condition of their pelvic floor muscles is not obvious unless there is an attempted penetration in the vagina. It is how the muscles can contract or clench leading to vaginal pain. This can be experienced commonly while having intercourse, inserting a menstrual cup or tampon.

The pain is often described as soreness, burning pain or dull ache. Some women may feel like there is a ‘blockage or wall’ inside the vagina preventing penetration. Occasionally, urination and defecation can also be affected and become difficult or abnormal.

It may sound like a new age problem but the prevalence of vaginismus is up to 15 percent among women. Shockingly, 1 in 4 women have painful sex regardless of the cause. There are various types of vaginismus that can affect women at any age.

tampon (1)
Inserting a tampon may be painful too in vaginismus. Image courtesy: Shutterstock

The common types of vaginismus include:

1. Primary vaginismus

Women with this condition experience lifelong pain at any hint of vaginal penetration. This pain may arise while inserting tampons and penetration during sex. The patients experience pain during their first attempt at sex and very often their relationship remains unconsummated. It’s also called lifelong vaginismus.

Their male partners often get the feeling of hitting against a wall when trying to insert the penis in. The pain subsides as soon as the penetration stops.

2. Secondary vaginismus

This is a condition which occurs when vaginal penetration is extremely painful due to a specific event. They reason for it can be gynecological surgery, menopause, yeast infection, childbirth, any traumatic event or some sudden relationship issues.

Women suffering from secondary vaginismus usually experience a normal sex life. Some women develop vaginismus after menopause. This occurs when there is a decrease in estrogen levels in the body and the vagina becomes dry and loses its elasticity. Adequate lubrication in the vagina after menopause makes sexual intercourse painful. It’s also called acquired Vaginismus.

3. Situational vaginismus

Situational vaginismus, as the name itself suggests, occurs in certain situations. In this form of vaginismus, pain may occur while having a sexual intercourse but not while inserting a tampon. Or it may occur only during pelvic exams. The pain may also occur while having sex with one partner but not with others.

tantric sex
Know why sex with your partner hurts bad! Image courtesy: Shutterstock

4. Global vaginismus

This type of vaginismus can be triggered by any object in all situations, for example, pelvic exam, tampon insertion, and sexual intercourse.

Causes of vaginismus:

  1. Over movement of the pelvic floor muscles can cause vaginismus.
  2. It can also result due to a trigger inside the body – potentially an infection.
  3. A traumatic gynecological examination.
  4. Sexual abuse or an episode of painful sex.
  5. A belief that sex is shameful and unpleasant.Some of the more common causes of vaginismus (tight pelvic floor muscles) include anxiety, stress, and back pain. However, abnormal holding patterns with urine or breath, traumatic childbirth experience, injury to the hips, joints or menopause may also impact.

    Treatment of painful sex condition called vaginismus:

You probably think of painful sex (dyspareunia) and vaginal pain (provoked vestibulodynia or vulvodynia) as gynecological problems. So you may be shocked to learn that physical therapy is a big part of the solution.

This isn’t traditional physical therapy, of course. It’s a specialized one called pelvic floor physical therapy. Pelvic floor physical therapy can dramatically reduce, even eliminate, vaginal and sexual pain. Its safe, delicate techniques have helped countless women enjoy pain-free, pleasurable intercourse.

yoga asanas for PMS
Try the pelvic floor therapy to be able to enjoy sex again! Image courtesy: Shutterstock

How does pelvic floor physical therapy work?

Your physical therapist will use manual (hands-on) therapy. For example, soft-tissue massage, trigger-point release, and myofascial release to calm the tightness in your back, pelvis, abdomen, hips, and thighs. Manual therapy increases blood flow, restores elasticity, reduces pain sensitivity, corrects structural imbalances, and melts away tender points.

Additionally, your physical therapist will teach you pelvic floor exercises, such as pelvic drops, to relax your pelvic muscles and open your vagina. She may use a biofeedback machine to train you to isolate and release your vaginal muscles.

If you’ve had a hysterectomy, C-section, or other pelvic surgery, your physical therapist may use manual therapy techniques to release adhesions (scar tissue). An ultrasound or cold laser to heal and soften any painful vaginal tears or thick, sore scars will be helpful.

Can kegel exercise help in treating vaginismus?

No, kegels are not the solution for vaginismus. Contracting already tight pelvic floor muscles will likely make it worse and cause further spasming.

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About the Author
Shazia Shadab Shazia Shadab

Lead physiotherapist, Cloudnine Group of Hospitals, Bangalore (Jayanagar)

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