When Sex Hurts
What happens when the process of "becoming one" in marriage brings pain, not pleasure? Or when every attempt at intercourse induces intense burning and the sensation of being torn apart inside? Many women live with an invisible handicap that robs them and their spouse of the enjoyment of sexual intercourse. It's called vaginismus, and it's possibly the most common cause of female sexual pain you've never heard of.
Commonly misdiagnosed, vaginismus is the involuntary and unconscious spasm of the muscles surrounding the vagina, making penetration painful or impossible. Estimates suggest that in North America alone, hundreds of thousands of women suffer from vaginismus to some degree. Statistics are hard to gather because many never come forward due to shame and embarrassment. Victims suffer in silence for years, never realizing they can find help.
My journey with vaginismus began 12 years ago. My husband, Brian*, and I had been married eight years when I gave birth to our second child. Labor was traumatic, and the baby was finally taken by C-section. After my recovery and with two babies in the house, my husband and I were tired but eager to resume the joy and comfort of intimacy.
Instead, sex brought anything but joy and comfort. Every time we had intercourse, I experienced intense burning pain. While I wanted to say "yes" to intimacy, my body said "no."
When my physician examined me, he found nothing physically wrong and said the pain should subside. But it didn't. In fact, it got worse. I didn't know what was happening, and fear kept me from telling Brian for two years. Many times I hid the tears. I thought if I told him, he'd be afraid to touch me.
With two toddlers and a full-time job, my excuse of being too tired for sex seemed justifiable, but I couldn't avoid all of Brian's sexual advances. Soon it became difficult to have intercourse at all. Penetration was almost impossible. Finally, I broke down and told him of my pain. He was afraid to hurt me further and for a time, sex stopped.
Annual visits to the gynecologist yielded no medical cause for my pain, and my shame and embarrassment kept me from opening up about it even to my closest friends. I couldn't imagine telling anyone "I can't have sex." I avoided Brian to escape continued failure in our sex life, and our marriage began crumbling. While I seemed to succeed in every other aspect of my life, I still felt as though "failure" was stamped across my forehead.
In the depths of this internal struggle, the Healer brought me to himself. Six years into vaginismus, I accepted Jesus as my Savior. Although I felt a weight lift from my shoulders, vaginismus was still a burden I couldn't give him. So much shame and isolation surrounded my sexual problem that I felt I couldn't even discuss it with God.
Through God's grace, my new-believer's heart softened and I began sharing painful details of my life with a godly woman who mentored me. She suggested I see a Christian counselor, which I eventually did.
By the time I started counseling, anxiety, depression, and marital difficulties complicated my treatment. I didn't even tell my counselor of my "little sexual problem" until several sessions into therapy. After tearfully describing my symptoms, she calmly said, "You have vaginismus." However, she hesitated to diagnose me until physicians ruled out all other medical reasons for dyspareunia, the medical term for painful intercourse, commonly caused by conditions such as endometriosis, pelvic inflammation, or bladder problems. Even after exploratory surgery to check for endometriosis, a diagnosis eluded my doctor.
Continued counseling revealed painful events from my past that had made sex and sin almost synonymous. A combination of verbal abuse, strict religious teaching, and silence about sex in my home created a deep sense of shame surrounding my sexuality. Though childbirth had triggered vaginismus, the main factors to continued symptoms were rooted in these issues. Through Christian counseling, the truth of God's unyielding joy, infinite love, and full acceptance replaced my emotional wounds, and freedom truly began.
Brian accompanied me to a few therapy sessions. On one occasion, our counselor asked him to sum up his feelings about our relationship. He simply said, "I feel alone." Tears came to my eyes. For the first time, I considered his feelings of being rejected, frustrated, isolated, and angry. He longed for oneness just as I did. But what could we do?
I started researching, and what I found surprised me. Vaginismus has been acknowledged for 100 years. Physicians Masters and Johnson studied it extensively in the 1950s. According to their study, "vaginismus is in all probability the most overlooked diagnosis, especially in gynecology. This statement particularly applies to the more moderate degrees of distress in given patients."
Further research revealed vaginismus falls into two categories. Primary vaginismus occurs when a woman has never achieved penetration, causing a marriage to go unconsummated. My condition, called secondary vaginismus, occurs after a woman has experienced sexual relations. Symptoms usually develop after some type of pelvic trauma—in my case, postnatal pain.
The causes of each woman's vaginismus are as unique as the woman. Psychological factors typically play the largest role in developing the condition. Trauma such as physical abuse, molestation, rape, or incest can lead to symptoms. When this type of horror is recalled, the body automatically reacts to avoid further pain and the muscles around the vagina unconsciously spasm. The mind is incredibly complex and the reason why some women develop symptoms and some don't is a mystery. However, misinformation regarding sexuality also can instill negative emotions toward what God created to be beautiful, comforting, and pleasurable. Carol Selander, a Christian counselor who has treated several women suffering from vaginismus, says she guides her clients to seek biblical truth in order to let go of moral misunderstandings and negative thoughts.
Due to misconceptions from my childhood, I assumed God and sex didn't belong in the same room together. Through therapy, I understood nothing could be further from the truth. Like many women, I longed to experience intimacy without shame and wanted God's blessing in my sexuality. I also realized our children deserve to know sex was God's idea, and he made it pleasurable because he loves us. In a world filled with sexual images and twisted information, it's up to us to deliver the right message of God's great gift.
Once I pinpointed the cause of my condition, I formed new beliefs about the spiritual connection between God and my intimacy with Brian. Through the truth of Scripture, advice from a few good books, and total honesty with my husband, the door to healing was opened.
Overcoming vaginismus is a step-by-step process that not only involves retraining the mind, but also the body. Therapy is a little unorthodox, but worth the final outcome. Physical treatment includes a combination of practicing Kegel exercises (contracting and holding the muscles used to stop urine flow), doing relaxation techniques, and using a graduated vaginal dilator to retrain the muscles surrounding the vagina to respond correctly.
Emotional and physical healing time varies, depending on the depth of emotions holding a woman in bondage and her willingness and ability to work through the physical steps. Treatment takes patience and prayer on the part of both partners.
Since beginning my research on vaginismus, I've come to realize my case is fairly mild. While I experienced shame and loneliness, I've since discovered other women who have endured utter emotional, physical, and spiritual devastation.
I can't imagine the pain of a couple never consummating their marriage due to primary vaginismus. I don't know the desperation of longing for a baby, but being unable to conceive because intercourse is impossible. I hate to think how many divorces have occurred because there was no reason given for a woman's inability to have sex. But I'm hopeful for the woman reading this right now who finally understands there's a name for her pain.
Brian and I are still walking the steps to recovery. Never are prayer, honesty, patience, courage, and compassion more important in marriage than when dealing with a sexual disorder. Romans 8:28 states "in all things God works for the good for those who love him who have been called according to his purpose." He will not waste any of our pain, and in "all things" we learn valuable lessons.
Though it's a challenge, vaginismus has become a bond that pulls our marriage together. We've learned to become more open and honest with each other—qualities that didn't exist between us before. Brian and I have found that if sex is to be mutually satisfying, as God intended, we must find oneness outside intercourse while we seek to find oneness within it.
Kate Cardwell is a pseudonym for a freelance writer who lives with her family in Wyoming.
Do You Have Vaginismus?
Do you experience intense burning pain when intercourse is attempted?
Does it feel as though your husband is "bumping up against a wall" while attempting penetration?
Have you been unable to have sexual relations because your vagina seems "too small"?
Does vaginal pain stop after discontinuing intercourse?
Can you point to physical or emotional trauma in your past that evokes shameful feelings toward sex?
Have physicians ruled out all other causes of female sexual pain?
If you answered "yes" to these questions, you may have vaginismus.
Resources for Recovery
Educating yourself about vaginismus is the first step to overcoming it. Some resources to start with are:
www.vaginismus.com: an Internet site dedicated to informing and treating vaginistic women
When a Woman's Body Says No to Sex—Understanding and Overcoming Vaginismus by Linda Valins (Penguin Books USA, Inc.)
A Woman's Guide to Overcoming Sexual Fear and Pain by Aurelie Jones Goodwin and Marc E. Agronin (New Harbinger Publications, Inc.)
Copyright 2004 by the author or Christianity Today/Today's Christian Woman magazine.
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When Sex Hurts
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