I dare you to find me a woman who hasn’t experienced pain during sex at least once in her life. In fact, pain during sexual intercourse is so common that there is a dreaded name for it—vaginismus. Vaginismus is the term doctors and pelvic floor therapists use to describe recurrent and involuntary tightening of muscles around the vagina during sex. It’s widely cited that 1 in 3 women will suffer from some degree of vaginismus in their lifetime, and every woman who has it will tell you it’s a bitch—trust me, I’ve been one of them.
I realized something was wrong with my vagina two years ago, after a drunken hookup where I was in so much pain I started bleeding. The next morning I went to a doctor who only swabbed me for STIs and recommended I wait a few weeks to see a specialist. There I was feeling broken, knowing this wasn’t an STI and thinking “man, what the eff is wrong with me?”
Step one: Don’t grin and bear it
Go to a doctor and get a referral for a gynecologist, a pelvic floor therapist and, if you suspect your pain is related to trauma, it might be worth seeing a sex therapist as well. DO NOT tolerate the pain and think it will get better with time on its own. It won’t.
Step two: Pelvic floor therapy
If pelvic floor therapy had a tagline it would be “It’s like pilates but for your vagina!” At first you may be tempted to roll your eyes because the pain you’re going through feels unfixable but, trust me, there is a reason these certified therapists make $50K a year. They will be able to help you. My PFT once told me that sometimes all it takes to cure vaginismus is as little as two sessions practicing breathing techniques and learning how to use a dilator on your own time.
Step 3: Let your future partners know
When you think you’re ready to have sex again, let your future partners know. You don’t need to give them the whole play-by-play or tell them that you’re “uber good at kegels” after pelvic floor therapy—in my experience all it takes is a simple “hey, I’m pretty sensitive, so we might have to take things slow and at my pace.” Then cue step four.
Step 4: Figure out what positions work for you
When my pelvic floor therapist and I decided after months of treatment that I was okay to start having sex again, she suggested I start by being on top. When you start intercourse on top you have full control of the speed and angle of penetration. Once you get over that initial muscle reaction, sex becomes a lot more comfortable.
Step 5: Use lube
Step 6: Keep practicing!
Vaginismus isn’t like a headache that goes away with some Advil. It’s an uncontrollable tensing of the pelvic muscles that takes time to completely shake off. After six months of regular pain-free sex with my partner, I still have some discomfort. If I have a stressful day at work and my muscles are tense, or if I’ve been sitting cross-legged all day, I still experience pain during sex. Doing the exercises my PFT gave me and checking in with my body helps me stay on track.