Vaginismus: am I the only one?

We first met Jennifer, a 22-year-old newlywed, two months after she married her long-term boyfriend, Mike. According to the couple, they had a good, loving relationship and enjoyed their wedding day to the fullest. But it was what happened following the ceremony and during the honeymoon that sent Mike searching for answers on the Internet.

Though Mike and Jennifer were intimate prior to their wedding, it was their mutual decision to refrain from actual intercourse until they secured their vows. Jennifer admitted feeling nervous about their first sexual encounter, and when Mike attempted to penetrate, Jennifer's legs tightened in a panic - she then felt a sharp, burning pain in her vagina and pelvic area, causing her to burst into tears. Both were admittedly confused by the experience, but hoped that their future encounters would be better.

Jennifer continued to experience tremendous fear and pain every time they tried to have intercourse - even Mike's reassuring words and gentle attitude did not seem to help. With their hopes crushed, they consulted her gynecologist who ruled out medical problems and dismissed it as nervousness, advising them to keep trying.

Jennifer then fell into a state of depression, fearing that something IS wrong with her body. She couldn't talk to her mother about her problem because sex was always a taboo topic. She felt even more of a failure thinking of her female friends who enjoyed and often talked about sex.

The medical name for this condition is vaginismus, a strong, involuntary muscle spasm of the pelvic floor (surrounding the vagina and bladder), often experienced with burning, pain and panic. The condition is sometimes the result of an injury to these muscles but, most often, it is due to deep fears a woman might have about her body and its functions. These fears can be a result of parental secrecy about intimacy/sex, lack of knowledge about how the body works, and/or frightening stories about painful sexual experiences. Vaginismus can also be a result of other traumas such as childhood illnesses where the body was repeatedly exposed to treatments, complication during childbirth, physical abuse, rape, verbal abuse and/or sexual abuse. Additionally, the trauma of witnessing any sexual act as a child could lead to such fears as well.

Recognizing that effective treatments must address the physical and the emotional aspects of vaginismus - we have pioneered a combined body-mind treatment approach by merging the expertise of urogynecologic physical therapy/sex therapy with psychotherapy/sex therapy for a comprehensive management of this complicated and sensitive problem.

We advised Jennifer and Mike to refrain from intercourse at first, a suggestion that brought a sigh of relief from Jennifer. She was then able to focus on the therapeutic process that included teaching her the anatomy of her body (how it worked, what happened during intercourse), discussing her feelings and fears regarding these issues, and inviting Mike to join in for some of the sessions for further support, understanding and guidance.

Breaking their vows of silence about vaginismus, Jennifer and Mike were able to find the help and answers they needed. Their hard work resulted in a complete recovery and they were able to have the dream honeymoon they always desired.