Dear SuzyKnew,  My girlfriend and I have been together for a while now and she says she wants to have sex, but whenever we get close to penetration she freaks.   I’ll get my penis in a tiny bit and she pulls away crying, saying that it is too painful.   I have never had another women react this way.  She won’t even let me try my finger or a dildo.   I know my penis is not off the charts big, so is it possible that her vagina is too small and tight for sex?  Or is something else going on? Do you have any advice?

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Dear Friend,

It sounds like your girlfriend could be suffering from Vaginismus, which involves involuntary and painful spasms of the muscles surrounding the vagina.  The pain can be so intense that women avoid inserting anything into their vagina, including a tampon or finger.  This is a complicated disorder that typically has both physical and psychological components.   I sympathize with you both and am glad that you are seeking out a solution.  Yes, there are treatments, and many women are able to overcome vaginismus and have fully satisfying sex lives.  As a caring partner, you can play an important role in her treatment and recovery.

Her first step should be to find a gynecologist who has experience treating this disorder.  Many women suffering from vaginismus avoid going to the gynecologist  all together for fear of having a pelvic exam.   A provider who has experience with these patients will not only be gentle, but they will be able to rule out a physical cause, such as an injury or infection.   

Her next step should be to consult a therapist specially trained in sexual disorders.  Vaginismus typically has a psychological root, and often co-occurs with depression and generalized anxiety disorder.   Women with this condition may have experienced some type of trauma or negative experience.   Depending on her religious and cultural upbringing, she may have received highly negative information about sex.

Depending on the source of the problem, her therapist may prescribe a combination of therapies, including individualized counseling, meditation and relaxation techniques.   Most treatments also include the use of dilators.  These are smooth rods of various sizes, meant to train the muscles of the vagina to accept penetration.

There are several great resources on the Internet on vaginismus.  There are private forums and live chats.  I read through several of these preparing this letter to you.  Many women express relief that there is a name for what they are experiencing.   Over and over again I read the statement, “I thought I was all alone”.   The website vaginismus.com has a wealth of information and is a good place to start.

Take Care