By Meryl Davids Landau
When you were in your 20s and 30s, you probably ignored random aches or other minor physical annoyances, and they usually went away. But now those symptoms can come back — often with a different cause, and calling for more serious attention.
Painful sex is often a woman's first sign that she has vaginismus. The pain happens only with penetration. It usually goes away after withdrawal, but not always.
Women have described the pain as a tearing sensation or a feeling like the man is "hitting a wall."
Many women who have vaginismus also feel discomfort when inserting a tampon or during a doctor's internal pelvic exam.
Doctors don't know exactly why vaginismus happens. It's usually linked to anxiety and fear of having sex. But it's unclear which came first, the vaginismus or the anxiety.
Some women have vaginismus in all situations and with any object. Others have it only in certain circumstances, like with one partner but not others, or only with sexual intercourse but not with tampons or during medical exams.
Other medical problems like infections can also cause painful intercourse. So it's important to see a doctor to determine the underlying cause of pain during sex.
Women with vaginismus can do exercises, in the privacy of their own home, to learn to control and relax the muscles around the vagina.
The approach is called progressive desensitization, and the idea is to get comfortable with insertion.
First, do Kegel exercises by squeezing the same muscles you use to stop the flow of urine when urinating:
Squeeze the muscles.
Hold for 2 seconds.
Relax the muscles.
Do about 20 Kegels at a time. You can do them as many times a day as you want to.
After a few days, insert one finger, up to about the first knuckle joint, inside the vagina while doing the exercises. It's a good idea to clip your fingernails first and use a lubricating jelly. Or do the exercises in a bathtub, where water is a natural lubricant.
Start with one finger and work your way up to three. You'll feel the vagina's muscles contracting around your finger, and you can always take your finger out if you're not comfortable.
For women whose vaginismus is related to fear or anxiety, therapy helps.