9:41, 24.Oct 2018
Have you and your partner tried to have penetrative sex, but it is incredibly painful for her? Do all angles seem to have the same result? While there are quite a few things that can make sex painful for a woman, if this is a consistent problem, then she might have vaginismus, a treatable but frightening condition that makes sex pretty much unbearable for a woman.
As with anything your partner is going through, the more you understand it, the better you can help. If you’re not familiar, vaginismus is “muscle spasms around the vagina which literally tighten the vagina, making penetration for sex very uncomfortable,” Mary Jane Minkin, M.D. OB/GYN at Yale University tells Men’s Health.
These spasms are completely out of your partner’s control.
“It's not something that the woman is trying to do—in fact, she's trying not to tense up, but it's almost as if her body isn't allowing her," Leah Millheiser, MD, an OB/GYN at Stanford University, tells Men’s Health. "It's almost an anxiety disorder of the pelvis. [As a woman], your head is saying yes, your vagina is saying no. And it's not just the vaginal muscles, it's the muscles of the legs, it's the muscles of the abdomen."
For a woman, the process to overcome it can feel incredibly frustrating and uncontrollable. Treatment for vaginismus can involve dilators, pelvic floor therapy, and, potentially, cognitive behavior therapy. As their partner, knowing as much as you can about the condition, and being there when they need you, can make a big difference. So, let’s get you educated and ready to help. This is what you need to know if your partner has been diagnosed with vaginismus.
Vaginismus is caused environmentally
There are so many different causes for vaginismus. Sadly, vaginismus is generally caused due to your partner experiencing some sort of trauma or forced association with sex.
“There are many reasons a woman may have vaginismus,” Minkin says. “She may have had a bad vaginal infection at one point, and was very uncomfortable from it—and the memory of that pain lingers, and she continues to tighten when she even thinks of penetration with sex. She may have been sexually assaulted at one point, and she [goes] back to thoughts about that assault when she is thinking about sex. She may have been taught for whatever reason that sex is sinful or evil, and she thinks about it, and tightens up.”
She may not be willing to discuss possible causes with you, and you need to respect that. Cognitive behavior therapy can help her work through these issues when she’s ready.
The best thing you can have is patience
Remember, your partner is currently having an involuntary reaction to sex. “Vaginismus is not something that is going to go away overnight with therapy ... patience is a virtue in this one,” Millheiser says. “If you think about it, that woman wants nothing more than to be intimate with her partner, and it's almost as if she feels like she's lost control over her vagina during sex. Now, this therapy is allowing her to gain control back. It's just remembering to be supportive. Follow her lead.”
You can help her with physical therapy
If you’re partner would like, try to help her with her physical therapy exercises. This may include dilator therapy, which involves inserting cylindrical devices into the vagina to help stretch it out.
“It's very important for the partner to be involved with the dilator therapy. They can use dilators and eventually move to fingers and eventually do more,” Dr. Millheiser says. “Again, that allows the woman to become comfortable with her partner, taking control again. It does breed intimacy, too. When you're doing dilator therapy with your partner, you can turn it into more of a foreplay type scenario, but making sure that the woman is the guiding force.”
Ask her what angle you should insert it, how far, and at what speed. Little by little, you two can work through this together.
She needs support, not pressure
The most important thing you can do for your partner is be supportive and listen to her needs.
“Be encouraging. I hear this a lot from my female patients: 'My husband or my boyfriend every day is saying, Have you done your dilators? Have you done your dilators?'” Millheiser says. “So put less focus on 'did you do it?' and more on 'what can I do to help you? You guide me, you tell me how you need me to help you with this, I'm here for you, I understand.'”
You can still be intimate in many ways
Just because you can’t have sex right now, doesn’t mean you can’t be physical. “Remember that intimacy can and should continue during treatment. You can still do everything but, and I encourage it,” Millheiser says.
“At some point, when the smaller dilators start to become more comfortable, and the woman can use them without difficulty, then I definitely recommend that she and her partner incorporate those dilators into foreplay, into sexual activity," Millheiser adds. "You can use fingers, you can use dilators. That allows the woman to become more comfortable.”
Together, try to look at this as a chance to think outside the box when it comes to pleasure.
You may experience some dysfunction as well
There’s a good chance you tried for quite some time to have sex before getting medical help.
“What ends up happening is sometimes the male can experience a little bit of erectile dysfunction because they've been trying and trying, and he eventually loses his erection. Sometimes that can turn psychological for the man,” Millheiser says.
Any guy it that position "definitely should speak to his doctor about that, a urologist or a primary care doctor to address what his needs may be,” she says. It’s not uncommon for this to occur, and shouldn’t be a cause for worry.
Talking things out with a sex therapist can help
Your dysfunction can come as a surprise. While speaking to a urologist or primary is important, a sex therapist may also help you move through this problem.
“In relationships, understanding and communication is the most important part,” Jessica A. Shepherd, M.D., MBA, OB/GYN and member of HealthyWomen's Women's Health Advisory Council, tells Men’s Health. “For men, communicating through a sex therapist is often helpful to address the psychosocial issues that may affect sexual intimacy.”