It's Critical to Support Your Partner if They're Dealing With Vaginismus

A consistent misconception some men believe is that sex is painful for women only during their first time. While the first time is often painful—though not always—women who suffer from vaginismus may experience pain every time they have penetrative sex. Vaginismus is the term for when a woman's body has an automatic reaction to vaginal penetration. The muscles tighten or contract, causing immediate pain and discomfort.

Women who experience vaginismus have no control over their vaginal reactions. Vaginismus can come on suddenly, happening after many successful sexual encounters, or it may be a consistent problem.

Whatever the case, if your partner has vaginismus, it's crucial you understand the condition and support her through this uncomfortable time. Vaginismus is treatable, but patience and understanding can go a long way in her recovery.

The causes of vaginismus

The partner of someone suffering from vaginismus can easily assume it has something specifically to do with them, but there are many causes.

"Many people think muscle spasms are the primary cause of vaginismus, but in reality, there can be several causes," said Lyndsey Murray, M.S., L.P.C., a counselor and certified sex therapist at Relationship Matters Therapy in Hurst, Texas.

Murray listed other causes aside from muscle spasms:

• Muscle tightness of the pelvic floor
• Fear of vaginal intercourse or pain during intercourse
• A history of pain during intercourse and your body no longer wanting to experience that pain
• Overall sexual anxiety

Sexual anxiety can stem from many places, such as poor sex education, religious-based teachings, past sexual trauma, or shame and guilt over sexual activity, Murray said.

Beyond psychological or emotional reasons, physical factors can cause painful penetration.

"Physical causes of vaginismus may include infections or injuries that cause pain during sex, hormonal changes that affect the vaginal muscles, endometriosis or other conditions that cause pelvic pain, vaginal dryness, which can be caused by menopause or certain medications," said James Elist, M.D., a urologist in Beverly Hills, California.

Sometimes this condition comes on after years of pleasurable sex and can stem from sexual trauma or a physical issue. Some women may not know they have vaginismus until penetration occurs.

"This condition is often experienced by individuals trying to use tampons or having sex for the first time," said Mel Davis-Hall, B.M.B.S., B.Med.Sci., a general practitioner and the medical director at the Lowdown, a platform for women's sexual and reproductive health based in the United Kingdom.

For some women, the pain stops once they get through the initial penetration, but in many cases, the pain continues.

The actual number of women who suffer from vaginismus is unknown. Some studies report high numbers of occurrences, while others suggest vaginismus is relatively rare, according to a review published in the journal Women's Health.

This discrepancy is likely the result of little research on the subject and sufferers' hesitation in seeking help. As the study notes, a diagnosis would likely require a gynecological exam, which would be painful and difficult for women with the condition to undergo.

How is vaginismus treated?

Vaginismus is very treatable. The process, however, is not immediate because it can take time to discover the root cause of vaginismus and work through that issue.

If the condition is brought on by a temporary physical factor, then treatment may be quicker. Painful sex caused by menopause or medications that cause vaginal drying can often be treated with lubricants, and infections can be remedied with appropriate medication.

If the condition is caused by an emotional issue—past trauma, fear, anxiety—then a combination of physical exercise, relaxation techniques and therapy can help.

"It's not a one-size-fits-all approach, but treatment is usually centered around managing feelings around penetration and exercises that gradually get you used to penetration," said Melanie Bone, M.D., an OB-GYN in West Palm Beach, Florida. "Psychosexual therapy and relaxation techniques based on mindfulness can be effective in helping reframe thoughts around penetration. Pelvic floor exercises can be used to help gain a sense of control over vaginal muscles, and vaginal trainers, in the form of tampon-shaped objects in different sizes, can be useful in gradually getting used to having something put in your vagina."

In certain situations, medications such as muscle relaxants and topical anesthetics may be prescribed to help reduce pain and discomfort during intercourse, Elist added.

It's important to remember that every person is different, and it may take time to find the appropriate combination of treatment for your partner's situation. Encourage your partner to seek help. A therapist or OB-GYN can help determine the treatment plan most effective for their needs.

Supporting your partner

The most important thing you can do for a partner with vaginismus is to support them. Support can come in the form of educating yourself about the condition, listening to them about their experience and never pressuring them into having penetrative sex. Pressure can only make the situation worse.

"Communication without judgment is key. Those suffering with vaginismus can often feel embarrassed and have a sense of shame," Bone said. "It's important to try to create a safe space for them to talk about how they are feeling about sex, how they might like to seek treatment and how you can be there for them during the process."

While supporting your partner is necessary, so is continuing intimacy in whatever ways you can. If penetrative sex is off the table while your partner is seeking treatment, you have many ways to continue a happy and healthy sex life.

Elist suggested sensual massage, oral sex, kissing, cuddling and sex toys as intimate alternatives to penetrative sex.

"It's important to remember that every couple's preferences and comfort levels are different and that what works for one couple may not work for another," he said. "Communication and mutual consent are key to exploring these alternatives and finding what feels good and comfortable for both partners."

"Any act that can be slow and sensual without intercourse or penetration can be very sexy and intimate," Murray added.

If you and your partner decide to continue with penetrative sex, keep in mind that the act may be too painful to continue through to orgasm. Changing positions when needed and taking the time to explore what is pleasurable for your partner could be helpful, Davis-Hall said. Talk to your partner. Ask them what they need and what they are comfortable with doing. Healthy communication leads to a healthy sex life, penetration or not.

"Men, if you are patient, loving and kind with your partner, that's going to help them lower any sexual anxiety they may be having to eventually make intercourse easier in time," Murray said.