Pain During Sexual Relations: Causes, Symptoms And Solutions
Vaginismus and Dyspareunia are sexual dysfunctions where pain is the main element. The lack of sexual education and lack of body knowledge seriously hinder the detection and expression of both problems.
The result is a continuous alert that distances the affected person from intimate relationships, a fact that translates into silent suffering. This week, Yolanda Segovia, collaborating psychologist of the Mensalus Psychological Assistance Institute tells us about these two dysfunctions and opens a reflection on the importance of their treatment.
Vaginismus is the inability to achieve vaginal penetration due to the contraction of the muscles surrounding the entrance to the vagina. When a woman becomes sexually aroused, she experiences a relaxation of the vaginal muscles. However, in Vaginismus, the muscle contracture is such that it prevents penetration.
On the other hand, Dyspareunia is the pain that both men and women can suffer in the pelvic area during or shortly after sexual intercourse. Pain occurs at the time of penetration, erection or ejaculation.
Focusing on the female sex, the pain factor is the protagonist in both problems. Still, the difference is important. In the case of women with Vaginismus, the reflex response of the muscles makes penetrative sex impossible (or extremely difficult). In the case of women with Dyspareunia, the pain seriously hinders pleasure during penetration but does not prevent intercourse.
In the case of Vaginismus, what aspects prevent the relaxation of the muscles?
Women with Vaginismus relate penetration with the feeling of danger This creates a completely automatic tension response that materializes in the vaginal muscles. This reaction generates great discomfort given that there is a desire to maintain a sexual relationship with penetration, but the physical reality is very different. A contradiction between mind and body then appears that is inexplicable to the person.
The result is an overwhelming feeling of lack of control and an explosive increase in anxiety. Among the factors that can cause Vaginismus we find sexual beliefs and values that create confusion, insecurity and, inevitably, generate a maladaptive response. On the other hand, this dysfunction usually has a beginning in the past.
Some women report having difficulties during the first menstruation stage when wanting to insert a tampon, irrational ideas about penetration or the possibility of getting pregnant, and even distorted ideas regarding the perception of their own genitals.
And in the case of Dyspareunia, why does it appear?
Among the aspects that can influence the appearance of pain are insufficient lubrication due to lack of erotic stimulation, vaginal dryness, premature sexual intercourse after surgery or childbirth, genital irritation from soaps, allergies to latex in diaphragms or condoms, and those aspects specifically of a medical nature (phimosis, frenulum, prostatitis, hemorrhoids, genital herpes, etc.).
We want to highlight that, in the case of this dysfunction, the pain must be constant and repeated during sexual relations ; Occasional pain does not mean there is a problem. Be that as it may, there is no doubt that discomfort greatly affects sexuality and can lead to the avoidance of relationships.
For this reason, if in doubt, it is advisable to consult a professional.
Do people who suffer from Vaginismus or Dyspareunia talk about their problem?
Most don’t do it, they make it a taboo subject. In the case of women with Vaginismus, educational work is especially important. The lack of awareness about one’s own body (usually there is no exploration) and social censorship, make the expression and normalization of aspects of a sexual nature even more difficult
This reality distances the affected person from different contexts (friends, colleagues, family, etc.) for fear of being misunderstood and labeled as “strange.” Fear increases day by day and alertness becomes an intrinsic element of the personality.
From Psychotherapy, what work is done in both cases?
In addition to the psychoeducational work and the detection of negative and destructive thoughts that is carried out in an individual therapy context, the work that is carried out in couples therapy is important. To solve the problem, it is essential to establish open communication in order to express discomfort and find mutual understanding.
In addition, The therapeutic work that facilitates change will be aimed at progressively addressing deep aspects The work of introspection, insight and emotional self-expression will accompany us throughout the process. The feeling of guilt, internal conflicts and, in some cases, unresolved feelings resulting from past traumatic experiences (e.g. history of sexual abuse, mistreatment, or rape), will be some of the issues that, from a systemic and integrative perspective, , we will repair.
What advice would you give to people who suffer from one of these two dysfunctions?
Especially, in the case of Vaginismus, the sensation related to lack of control contaminates the rest of personal contexts. The discomfort crosses the purely sexual border and translates into a fear that goes much further.
The inability to have penetrative sexual relations even if you feel the desire , little by little diminishes the ability to seek pleasure and satisfy one’s own needs. Ignoring this problem can seriously impact a woman’s self-esteem. Fear translates into more fear; This is why it is difficult to talk about the problem and consult a professional.
Our recommendation is always to approach the problem from a holistic view and, above all, consider the possible organic causes. Once discarded, the work from individual and couples psychotherapy is what will help the person regain self-confidence and, above all, not live in a continuous struggle, thus managing to have control of the situation and stop “ escape”.
In this sense, couple communication is essential to reaffirm the right to express and empty all that accumulation of feelings that, unconsciously, were one day reflected in an essential organ.
