Dear WholeFamily Counselor,

I have other problems but right now I'd like to talk about this problem. I experience pain in my vagina rather easily. I have a 13-year-old daughter and I am 40 years old, my husband is two years older. He is a little inhibited and my fear of pain worsens the matter. I have always reacted to vaginal examinations with terror and only a very sensitive doctor is able to get me to relax to a certain extent and examine me without causing me much pain.

The only time I tried using a tampon, I couldn't bring myself to do it properly and I fainted briefly. I am unable to insert my finger in my vagina and can't get my partner to do it either. He is also nervous. I am quite sure and doctors have also told me that there is nothing physically wrong with me, it is just psychological. Since romance has always been more important to me than sex, I have neglected the matter, but is it one of the factors affecting our sex life, which gets disturbed only too easily? Is it a matter for concern? Is there anything I can do about it?

Dear "Fear Of Pain,"

You seem to be describing a sexual problem called "vaginismus," which is involuntary spasms of the muscles surrounding the vaginal opening at the time of penetration. Most of the time it is caused by fear of pain, which is what you have identified in your letter. You ask if it is a matter of concern -- it depends on how you and your husband feel about sexual intercourse or other activities concerning vaginal penetration. If your sex life were fulfilling for both of you without these activities, I would not automatically consider it a problem. But if the pain is getting in the way of both of your enjoyment, there are ways to treat the problem.

The focus of the treatment is to change the automatic response of clenching the muscles putting you in control does this. You can learn how to desensitize this area by putting objects of increasing sizes into your vagina -- you control the pace of the treatment.

At the beginning, I would encourage you to get to know the muscles I'm referring to by the following method: While urinating, stop mid-stream, then continue urinating, then stop again, until you can identify the muscles you are using to do this. Then practice the same contractions at other times. When you first start with penetration, it's important to contract these muscles; then, when they are relaxed, you begin to start penetration. You can use any objects that are smooth and safe for the vagina -- i.e. tampons, fingers, cucumbers, dildos.

What's most important is to remember that penetration should not be painful. If it is, chances are you are clenching your muscles and you should go back to practicing contracting and releasing. Your vagina should be well lubricated when attempting penetration -- you can use a vegetable oil or a vaginal lubricant, like K-Y Jelly. After you feel comfortable with inserting objects, increase sizes until you reach the approximate size of a man's penis. Then you can have your husband follow the same procedures, with you directing his actions. You should let him watch you do it to yourself first, to show him that it isn't painful.

When you and your husband feel comfortable with this, you can proceed to intercourse. It should be done slowly, with you sitting on top of him and inserting your husband's penis the same way you did with the objects. Make sure you are well lubricated and relaxed. Good luck!

Sincerely,

Marsha Ellentuck, MSW