Relationship Rehab: Woman’s ‘embarrassing’ bedroom issue

A woman has opened up about a “painful” problem in the bedroom – explaining it’s ruining her love life and she wants it to stop.

Welcome to Relationship Rehab, news.com.au’s weekly column solving all your romantic problems, no holds barred.

This week, our resident sexologist Isiah McKimmie hears from a reader whose struggles to have sexual intercourse without it causing pain.

QUESTION: I have a really embarrassing problem that only seems to be getting worse. I’m 25-years-old and haven’t had many sexual partners because of this issue.

Basically, foreplay, kissing, and all of that is brilliant but when it comes to penetration, I just can’t seem to “open up” for want of a better phrase. It’s almost like my vagina closes up as soon as a penis comes near it.

If the man carries on then it’s painful and I have to ask them to stop. This happens with casual encounters and serious relationships and it’s stopping me from forming bonds with men I like. They take it personally and try to “fix” me with more foreplay but it doesn’t seem to help. What can I do?

A reader asks news.com.au’s sexologist, Isiah McKimmie, how to overcome genito-pelvic pain/penetration disorder. Picture: iStock

ANSWER: I’m so glad you reached out. It sounds like you’re experiencing what was previously known as ‘vaginismus’.

It’s now officially known as genito-pelvic pain/penetration disorder. Don’t be scared by the long, complicated name. It’s relatively common, estimated to affect up to 6 per cent of women and there are proven treatment options available.

What is vaginismus or genito-pelvic pain/penetration disorder?

Genito-pelvic pain/penetration disorder, or vaginismus, involves involuntary contraction of the pelvic floor muscles during penetration or attempted penetration. It makes penetration painful or impossible.

Many people describe attempting penetration as ‘like hitting a brick wall’. Some women find that they’re also unable to use tampons or to have a Pap test due to the pain.

Vaginismus can also inhibit your ability to enjoy penetration intercourse with a partner and for some women can contribute to high levels of anxiety around sex or intimacy.

You might also hear the term ‘dyspareunia’ used, which means painful intercourse.

Genito-pelvic pain/penetration disorder makes penetration painful or impossible. Picture: iStock

What causes genito-pelvic pain/penetration disorder?

There are a number of possible causes of genito-pelvic pain/penetration disorder, which can be both physical and psychological.

At times, it can occur as a result of a physical issue that caused pain initially and caused the body to become tense with the expectation that penetration will be painful in future. Sometimes there is no known physical origin. That’s normal too.

Some of the causes of vaginismus can include:

• Urinary tract infections

• Yeast infections

• Endometriosis

• Other pelvic pain or chronic pain conditions

• Trauma while giving birth

• Past sexual assault

• Fear of pain or fear of sex

• Negative beliefs about sex

• Relationship issues

• Poor body image

There are higher rates of vaginismus in people with strong religious upbringings and in women who have been warned that sex will be painful.

While there’s often a psychological component to vaginismus, the pain isn’t ‘just all in your head’ as some well-meaning professionals might tell you. The pain you experience is very real.

How to treat vaginismus or genito-pelvic pain/penetration disorder

You may hear unhelpful suggestions like ‘just have a glass of wine’ or ‘use lubrication’ shared by professionals who aren’t experts in pelvic pain. Suggestions like this or trying to ignore the issue can make it worse.

There’s nothing wrong with you and you don’t need to tolerate pain during sex. There are proven treatment options available.

Your first step is to get confirmation of what’s going on. It can feel scary and embarrassing to reach out for help, but speaking to a trusted GP or gynaecologist can help ensure that there’s nothing else going on that needs to be addressed.

Finding the right professional for you can take some time. Please don’t accept an explanation that ‘the pain is just in your head’ or that it’s normal. Make sure that the professional that you see is willing to take your pain, and treatment, seriously.

If there are no additional physical issues to be addressed, here are some treatment options that can help you.

You do not have to tolerate pain during sex as there are ways to treat genito-pelvic pain/penetration disorder. Picture: iStock

Visit a pelvic-floor physiotherapist

Using trigger point therapy, education and/or vaginal dilators, a trained pelvic floor physiotherapist can help release tension in your pelvic floor muscles, eliminating pain and allowing penetration to be possible.

Get support from a sexologist or sex therapist

A sexologist or sex therapist can help you address negative beliefs you may have around sex, help you learn to be connected to your body, help you find ways to increase your sexual pleasure and support you to navigate tricky relationship issues that can arise due to an inability to have penetration sex.

Seeing a sexologist can support you while you also see a pelvic-floor physiotherapist.

A sexologist or sex therapist can help you learn how to be connected to your body. Picture: iStock

You may be encouraged to use ‘vaginal dilators’

The professionals you see may suggest using vaginal dilators – to help you gradually become used to penetration and reduce your anxiety about it.

Be gentle on yourself

Addressing any kind of sexual or pelvic pain can be daunting at first, especially if you’re not used to talking about sex. Be gentle on yourself as you go through this process. Sex can be lighthearted and enjoyable with the right support.

Isiah McKimmie is a couples therapist, sexologist, sex therapist and lecturer. To book a session with her, visit her website or follow her on Instagram for more advice on relationships, sex and intimacy.