Ask Dr.Berman: We Never Consummated Our Marriage
When a woman finds penetration painful it could be a condition much more serious than just nerves — it could be the medical condition known as vaginismus.
Q: I got married last August and still have not been able to have sex. When we try, it hurts, even though he says he’s barely in there at all. In fact, I’m not sure if my problem is physical or psychological. I went to the gynecologist shortly before we got married, but her attempts to do a Pap smear were painful and unsuccessful — and she was very rude to me. I’m afraid to go back to the gynecologist, but obviously I’m going to have to do that at some point.
A: I am sorry to hear that your gynecologist was rude to you. Instead of brushing off your concerns or acting brusque, she should have realized that your painful Pap smear might be the result of a condition known as vaginismus.
Vaginismus occurs when the vaginal muscles spasm involuntarily, making intercourse painful, or even impossible (the same goes for vaginal exams, which explains why your Pap smear was unsuccessful). Soon, the pain leads to psychological symptoms such as anxiety and frustration. Hence, even if you want to engage in sex, you might not be able to due to painful spasms. Soon, you start to associate sex with that pain, and you start to avoid sexual activity altogether.
Vaginismus can often be a result of prior genital pain or sexual trauma. Treatment is comprehensive: Kegel exercises and pelvic-floor therapy can help to train the body to relax, and it can also help you feel more comfortable and in control of your sexual response. Sometimes an evaluation and treatment by a gynecological physical therapist can be a tremendous help in resolving pelvic pain and vaginismus. However, that is just the physical part of the equation. Learning how to relax and enjoy sexual activity will require additional assistance, and a sex therapist can be invaluable to you and your husband during this journey.
Furthermore, since you don’t mention any past sexual history, I assume that you might be a virgin. This could be part of the issue that is causing you to clench up. If you have never had sex before, you might be anxious or overwhelmed by the thought of it. This is not uncommon in women who have never had sex, particularly if that decision is based on religious or moral beliefs. After decades of not having sex, it’s hard to simply flip the switch once you are married and tap into that sexual side of yourself.
The best thing would be to see a gynecologist (one who is not rude to you!). Ask a friend or a family member to recommend a gynecologist who is understanding and kind. During your visit, your ob-gyn can give you a referral to a gynecological physical therapist in your community. From there, the physical therapist will work with you to gain control of your pelvic-floor muscles. Your pelvic-floor muscles are key to your sexual satisfaction, as well as your ability to have sex in the first place! Good luck…and remember, there are plenty of amazing, compassionate gynecologists out there, and once you find one, you’ll be able to get on track with your sex life.
— Dr. Laura Berman
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