The ability to enjoy a healthy sexual relationship with your partner is crucial not only for fertility and pregnancy, but is also an important aspect of life as a couple. However, very often, the pressure to conceive is the main driving force for couples to seek treatment.
Sex shouldn't be painful. Causes of painful sex include physical or psychological factors and, quite often, may be a combination of both. Physical causes include vaginal dryness, infections, endometriosis or ovarian cysts.
Often, no obvious cause is found. In such cases, pain during sex may occur due to an involuntary spasm of the muscles surrounding the vagina called 'vaginismus'. Discomfort and pain are experienced unexpectedly during attempts at intercourse. The pain results from the tightening of the muscles around the vagina. Vaginismus is very distressing and in severe cases, can lead to non-consummation of marriages.
Vaginismus may be caused by a past history of emotional or sexual abuse, or past physical trauma due to a bad childbirth experience or pelvic surgery. Usually however, there is no explanation. At the root of the problem is fear and anticipation of pain. As the body anticipates pain, it reacts by tightening the vaginal muscles to protect itself. Repeated attempts at sex then lead to a viscous cycle of pain and worsening fear. Under such circumstances, male sexual dysfunction commonly occurs with the male partner experiencing decreased libido and erectile dysfunction.
The treatment of vaginismus involves psychological counseling and retraining of the pelvic floor muscles with pelvic floor exercises (Kegel exercises). The pelvic floor muscles are trained to contract and relax under conscious control. The aims of treatment include: ability to overcome vaginismus, ability to have normal sexual intercourse, and, for couples hoping to conceive- achievement of pregnancy. Fortunately, with appropriate treatment, success rates are usually very high.