Painful sex is often brushed aside as something women just have to endure. But what if it happens every single time? Almost 60% of women in Singapore struggle with low sexual function, with vaginismus as a leading cause.
Dear women, whether through experience, sex education in school, or our own mother’s teachings, we all know that our first time can be a physically uncomfortable, and even agonising event.
From nervousness to insufficient lubrication, there are a variety of reasons why it might be painful.
But what if sex is painful every single time?
Female sexual dysfunction, which can make intercourse stressful for yourself and your partner, is a highly prevalent issue, but it’s never talked about openly. Yet in Singapore, almost 60% of women have low sexual function, with its most common contributor being a condition known as vaginismus.
Despite the pain this condition can give us, most of us choose to suffer in silence, either too ashamed to reach out for help, or assuming that we just need to grit our teeth through it.
But here’s the truth: sex shouldn’t hurt. And if it does, it’s time to talk about why.
An Introduction to Vaginismus
Vaginismus is characterised by involuntary contractions of the vaginal muscles, making penetration painful or impossible. It has been described as a tightening or burning sensation, or the feeling of “hitting a wall” during attempted penetration.
It can occur even if we try to insert a tampon, or when contact is made near the vaginal area, such as for a gynaecological exam.
It is typically categorised into two types.
- Primary Vaginismus: This is a lifelong ailment, when a woman has never achieved a pain-free vaginal penetration.
- Secondary Vaginismus: Women who develop this have previously been able to have intercourse with no issue, but later experience difficulties.
The pain ends when attempts at vaginal entry stop, and it doesn’t really interfere with any other aspects of our lives.
So how are we able to get it in the first place?
What Could Cause It?
The cause of vaginismus varies across individuals – there is no single cause of vaginismus.
Factors such as past sexual trauma, surgery, life changes like menopause, and even another medical condition can lead us to develop it, particularly in the case of secondary vaginismus.
But there are also other reasons why vaginismus is a problem for even young women with no sexual experience.
One of them could be the fear of any perceived pain associated with the tearing of the hymen or pregnancy.
We’ve learned vicariously that first-time intercourse and the process of giving birth can be demanding on the female body. This psychological aversion can lead us to instinctively tense up during sex.
Another major reason is our social or religious upbringing.
In highly conservative Asia, sex and masturbation may be considered taboo topics for many, and can engender a sense of guilt or fear regarding intimacy. This can create a deep-seated anxiety towards the act of sex itself, and negatively influence the outcome of such an act.
And because vaginismus only flares up during any attempts at penetration, virgins may not even realise they have this condition until their first sexual encounter.
According to Health2u Physiotherapist Laura O’Byrne in CNA: “The culture here is so different, generally tampons are not used for menstrual health – it’s all pads. And masturbation is something that tends to get looked down on. So until you get married, you’ve not had anything inside your vagina.”
“Then you get married, you try to have sex for the first time and it’s…horrible.”
When such a significant moment is marred by physical pain and emotional distress, it can be overwhelming and disheartening for individuals and couples.
How Can We Treat It?
While vaginismus can make intercourse extremely challenging, note that it is not the result of a lack of arousal. However, if left untreated, it can make you less interested in sex, or magnify any distress or frustration you feel, and worsen your condition.
But if you can give yourself the courage to seek help for this condition, it will set you on a path towards sexual healing and recovery.
And that initial step you can take? Seeing a doctor.
Recommendations for gynecologists who can treat vaginismus/perform hymenectomy
byu/Technical-River-1031 inaskSingapore
Discussing this issue with healthcare professionals and therapists is important for managing vaginismus and the mental toll it can take. So don’t be afraid of being honest about your struggles, or even your concerns regarding the consult itself.
“The first thing I tell them is that I’m only going to go as far as they want me to – they are 100 per cent in control. And if that means I only get to the entrance of their vagina, that’s fine. Sometimes just assuring them I’m not going to prod something into them is enough to promote relaxation,” said O’Byrne.
Very rarely does this require surgery. Depending on the diagnosis and any personalised recommendations, some treatment options available to you include:
Physical Therapy
One of the most effective treatments is learning to relax the vaginal muscles through pelvic floor therapy. Exercises like controlled breathing, stretching, and gentle muscle relaxation techniques can help ease tension over time.
You may also undergo dilation training, which involves inserting a tube-like device into your vagina for a short period, with the goal of gradually improving flexibility.
Rest assured that your doctor will further educate you on your condition, and provide clear guidance on any of these activities should they be prescribed to you.
Psychological Support
This may involve counselling to address any underlying emotional issues or trauma that may be contributing to vaginismus.
Going through cognitive behavioural therapy can also help you understand and reframe any negative thoughts and behaviours that may be exacerbating your condition.
Medical Treatments
In some cases, topical oestrogen creams (for menopausal women) or muscle relaxants may be prescribed.
However, medical interventions are usually a last resort. Most women see improvement through therapy and physical training alone.
Conquering Our Fears and Reclaiming Our Womanhood
Comment
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Vaginismus is common, but the shame surrounding it makes women feel like they’re suffering alone. That needs to change. Every woman deserves a fulfilling sex life – one without fear, shame, or pain.
If you or someone you know is struggling with vaginismus, reach out to a trusted gynaecologist, physiotherapist, or sexual health specialist. With patience and perseverance, you can find relief and enjoy a fulfilling intimate life.
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References
- Cleveland Clinic. (2020, October 28). Vaginismus. Retrieved from: https://my.clevelandclinic.org/health/diseases/15723-vaginismus
- Cleveland Clinic. (2023, May 10). Vaginal Dilators. Retrieved from: https://my.clevelandclinic.org/health/treatments/24971-vaginal-dilators
- Cronkleton, E., & Burford, M. (2022, September 1). What Is Pelvic Floor Relaxation, and Why Should I Do It? Healthline. Retrieved from: https://www.healthline.com/health/fitness-exercise/reverse-kegel
- Goodman, B. (2024, May 4). Vaginismus. WebMD. Retrieved from: https://www.webmd.com/women/vaginismus-causes-symptoms-treatments
- Herndon, J. (2020, March 24). What Is Vaginismus? Healthline. Retrieved from: https://www.healthline.com/health/vaginismus
- Jaafarpour, M., Khani, A., Khajavikhan, J., & Suhrabi, Z. (2013). Female sexual dysfunction: prevalence and risk factors. Journal of Clinical and Diagnostic Research: JCDR, 7(12), 2877–2880. Retrieved from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3919309/
- Loy, S. L., Ku, C. W., Cheung, Y. B., Godfrey, K. M., Chong, Y. S., Shek, L. P., Tan, K. H., Yap, F. K. P., Bernard, J. Y., Chen, H., Chan, S. Y., Tan, T. Y., & Chan, J. K. Y. (2021). Fecundability in reproductive aged women at risk of sexual dysfunction and associated risk factors: a prospective preconception cohort study. BMC Pregnancy and Childbirth, 21(1), 444. Retrieved from: https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-021-03892-5
- Salamat, H. (2021, November 16). Treatment for vaginismus: Where women can get help for painful sex. CNA. Retrieved from: https://cnalifestyle.channelnewsasia.com/women/painful-sex-vaginismus-dyspareunia-treatment-gynaecologist-287546
- SingHealth. (n.d.). Vaginismus. Retrieved from: https://www.singhealth.com.sg/patient-care/conditions-treatments/vaginismus
- Smith, L. (2024, July 17). What you need to know about vaginismus. Medical News Today. Retrieved from: https://www.medicalnewstoday.com/articles/175261
