Why does sex hurt so much for so many women?

PSA: Sex should not be painful.

We are guessing you have never heard of Vaginismus. Even though it is the primary female cause for sexless (unconsummated) marriages and one in 2000 women experience it (experts believe it is widely under reported due to women feeling ashamed, embarrassed or even that this kind of pain is normal).

It may be hard to pronounce, but this is what it is: the vagina muscles tighten involuntarily, making sexual intercourse very painful. Many women will experience it at some point in their life, regardless of their sexual activity.

So, why does this condition develop?

Speaking to Mamamia, Dr Ginni Mansberg explained vaginismus can be particularly distressing as we don't really talk about it.

There are so many different causes, which include psychological and physical factors.  These include:

• rape, sexual abuse or assault in the past
• unpleasant sexual intercourse
• medical conditions such as UTIs and chronic pain syndromes
• childbirth
• fear of getting pregnant
• fear the vagina may be too small for any penetration

As for how it feels? Rather than try to describe it, here are stories from three women who have experienced Vaginismus themselves:

"Every time I had sex with my boyfriend, it was painful. The more we did it, the more unbearable it became and the more I made excuses.  I initially endured the pain but then it became completely intolerable.  Even after a year of being sexually active with each other, I was so embarrassed to tell him just how painful sex was for me.  It felt as though my vagina had a wall, and nothing could break through that wall. Not a tampon, not a finger and especially not a penis.

"After two years of tolerating the painful sex, I told my GP when getting my first pap smear. I got it checked out and almost immediately saw a physiotherapist. It was really hard for my partner and I, he just didn’t understand.  For him, if it it was all in my mind then all he had to do was relax my mind. But for me, it was a physical barrier that was out of my control. It's not that I didn't want sex, it's that I physically couldn't have it.” - Kate, 20*

“Originally it was just a fear, an exacerbated fear of sex, which a lot of women my age have. Then as it developed, with bad partners and people who weren't very patient with me, it just got very, very bad really quickly...

"I thought all cis-gendered, heterosexual women faked it. I thought we'd all subscribed to some hilarious inside joke where, in a parallel universe, we'd laugh over coffee about how, as much as sex hurts, we all wanted it.” - Madison, 23

"In between [physiotherapy] appointments, my homework is to insert a single finger, then a plastic tube, into myself every day after applying a healthy dose of numbing cream, lightly pressing against the vaginal walls to allow the muscles to soften under the pressure…

"Humour and openness with others have helped me more than anything. I’m less shy about telling my friends about my vaginismus now and, just before the breakup of my relationship, I even opened up about it to my mother, who surprised me by being supportive and nonjudgmental, even though she doesn’t quite understand it completely. Sometimes, my roommate cheerily sings out, “Have you vigorously fingered yourself today?” We laugh because the alternative is crying, and I don’t want to do that anymore." - Giselle

LISTEN: Dr Ginni shares the biggest misconceptions women have about their bodies (post continues after audio...)

What should you do if you think you have Vaginismus?

To treat this condition, consult your GP.

For Dr Ginni, one of the biggest problems she sees when treating women with vaginismus is that we still don't really understand it, know for sure why it happens or have great treatments for it.

"There are a series of vaginal dilators that the woman uses on herself and many gynaecologists still use these," she said.

"These dilators get bigger and bigger until they are the size of a penis but sex can still hurt as the vagina goes into spasm. My advice is to go to a great pelvic floor physiotherapist and to see a sex therapist that is reputable."

Surveys have shown that the success rate of Vaginismus after it has been treated is 100%, although it will not treat itself and professional help is required.

According to Sexual Health Australia, physiotherapy is one of the most common forms of treatment. This involves musculoskeletal, vulvar and pelvic floor assessments via physical examinations. It also often involves the use of dilators.

Counselling and therapy has also been proved to work. Because this condition is often caused by physiological trauma, physiological treatment is often used to cure it.

Well, there you have it. The condition you've probably never heard of: Vaginismus. If you're experiencing pain during sex, see your doctor. And, while you're there, ask them how you pronounce Vaginismus.

*This name was changed to protect identity.