Help for Vaginismus and Pelvic Pain During Sex: What to Expect in Sex Therapy

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We’re told that sex is supposed to be enjoyable and pleasing. As one of the only species that have sex recreationally (as in not exclusively for repopulation), isn’t it supposed to be, well, recreational?

Unfortunately, not all women experience pleasure with penetrative sex — and it can be extremely painful for some women. For example, women with vaginismus experience pain with any type of penetration, whether with a penis, tampon, menstrual cup, or even medical instruments used by a gynecologist.

What Is Vaginismus?

As we mentioned briefly above, vaginismus is a condition that causes penetrative sex (and other acts of vaginal penetration) to be extremely painful or even impossible. But what exactly is vaginismus? Essentially, vaginismus is a sexual pain disorder characterized by persistent and involuntary spasms in the pelvic floor muscles. In simple terms, these spasms make penetrative intercourse painful or even impossible. 

Often, the term vaginismus is used in conjunction with the term genito-pelvic pain/penetration disorder (GPPPD). This term is used as an umbrella term to refer to various vulvovaginal problems, such as vaginismus. When an individual has GPPPD or, more specifically, vaginismus, it can be very difficult for them to undergo gynecological exams, insert tampons or menstrual cups, or have penetrative sex because the muscles in the pelvic floor or around the opening of the vagina can spasm involuntarily. 

There are a few different types of vaginismus that can also have different symptoms, pain levels, emotional impacts, and treatments. The four categories of vaginismus are:

  • Primary vaginismus – a lifelong condition that begins the first time the individual tries to insert anything into the vagina.
  • Secondary vaginismus – pain and inability to have penetrative sex or insert objects into the vagina that stem from a specific event or take place after someone has already experienced sexual function.
  • Global vaginismus – symptoms of vaginismus occur in response to any type of penetration, sexual or not.
  • Situational vaginismus – symptoms of vaginismus occur only in some types of penetration. For example, symptoms of vaginismus may occur when trying to have penetrative intercourse but not when getting a medical exam from a gynecologist.

When May You Want Support?

First things first, pain during sex (dyspareunia) is extremely common in women. The American College of Obstetricians and Gynecologists report that three out of every four women experience pain during sex at some point during their lives. That is an incredibly high number. 

This said, vaginismus is one type of sexual dysfunction that can worsen and lead to incredible stress and frustration if left untreated. Unfortunately, in reality, GPPPD is under-researched, and we do not know as much about it as we would like to. But this does not mean that there are no ways to get support and treatment for it. Realistically, there are several approaches to treating symptoms of vaginismus, but if you want to have the most success in finding and treating the underlying cause and symptoms themselves, you may want to consider seeking help from a sex therapist.

How Sex Therapy Can Help

The unfortunate truth is that we are often told to “relax” and have a glass of wine before sex, and everything will be ok. But, in reality, this will not solve the problem, and the intercourse can still end up being extremely painful or impossible. 

So, how can you actually improve your situation? Well, a sex therapist can help you not only discover the underlying cause of your sexual pain, but they can also help you to get the treatment you need for your particular situation. 

What to Expect from Sex Therapy

If you are starting sex therapy for vaginismus, or other sexual discomfort disorders, you may wonder what you’ll cover. Of course, each sex therapist’s approach will be different, and each treatment will be customized to cater to the individual’s needs, but there are some topics and techniques that your therapist will likely cover. These are:

  • Talking about a family history of sexual dysfunction
  • Talking about any trauma or possible causes for the symptoms of vaginismus
  • Cognitive behavioral therapy
  • Pelvic floor therapy
  • Address body dissociation
  • Slowly begin to practice with vaginal insertion
  • Relaxation techniques
  • Begin to introduce partner involvement

As mentioned above, everyone’s treatment will be different. The goal of sex therapy is to help you overcome your challenges and connect intimately with your partner in the way you want. Because sexual dysfunction is such an incredibly stressful and complicated problem that affects both you and your partner, it is almost always best to include your partner in the therapeutic process. This way, you can work through the problem together.

Tips for Coping with Vaginismus and Pelvic Pain During Sex

Like most issues of sexual dysfunction, symptoms of vaginismus or GPPPD can often be relieved with the right treatment. But, treating these conditions can take time. So, here are some tips that you and your partner can use to cope while you are making efforts to address any underlying causes and treat any symptoms you may be having.

Recognize it

The first thing that you need to do to effectively cope with vaginismus or other pelvic pain during sex is to recognize and accept it. It does not have to be embarrassing or alienating. As we mentioned earlier, 3 of 4 women experience sexual pain at some point in their lives. While you may be experiencing more frequent and extreme sexual pain (or limitation), there is nothing wrong with you. You simply need to take a little extra care and consideration to address what is going on in your body.

Be Patient

We said it earlier, and we’ll say it again. Treating vaginismus will take time. You must give yourself this time. Rushing yourself will only lead to more stress and frustration — which can worsen the situation rather than improve it. 

Involve Your Partner

Sexual dysfunction can be incredibly stressful and cause unwanted distance between partners. In order to help close that distance, you can bring your partner into your journey to treat your symptoms. This can show them that you are trying to work out what may be keeping the two of you from consummating your relationship. It can also help you become more intimate and boost your ability to talk about issues and work on solutions together.

Seek Help

As we noted earlier, without help, it can be quite challenging to treat vaginismus. But, given the right tools and techniques, you may be able to completely address any underlying issues and be free to enjoy your intimate relationship as you’d like. Sex therapy can help you to achieve this. In sex therapy, you can talk about what is going on and how that has affected your relationship. This can allow both you and your partner to move past the hurt you may have been feeling due to vaginismus and move on together into your new chapter.

So, if you or your partner are experiencing trouble with pain during penetration, please do not hesitate to get in touch with one of our sex therapists today!


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