yes, therapy helps!
Pain in sexual relationships: causes, symptoms and solutions

Pain in sexual relationships: causes, symptoms and solutions

March 1, 2024

Vaginismus and dyspareunia are sexual dysfunctions where pain is the protagonist. The scarce sexual education and the corporal ignorance seriously hinder the detection and expression of both problems.

The result is a continuous alert that moves the affected person away from intimate relationships, a fact that translates into silent suffering. This week, Yolanda Segovia, a psychologist collaborating with the Institute of Psychological Assistance Mensalus , he talks about these two dysfunctions and opens a reflection on the importance of his treatment.

What differentiates Vaginismus from Dyspareunia?

Vaginismus is the inability to achieve vaginal penetration due to the contraction of the muscles that surround the entrance of the vagina. When a woman becomes sexually aroused, she experiences a relaxation of the vaginal muscles. However, in Vaginismus, the muscular contracture is such that it prevents penetration.


In contrast, the Dyspareunia is the pain that can suffer, both men and women, in the pelvic area during or shortly after sex. 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 it impossible to have sex with penetration (or extremely difficult). In the case of women with dyspareunia, pain seriously hinders pleasure during penetration but does not prevent intercourse.

In the case of Vaginismus, what aspects prevent the relaxation of the musculature?

Women with Vaginismus relate penetration to the feeling of danger . This creates a fully automatic tensional response that materializes in the vaginal muscles. This reaction generates a high level of discomfort since there is a desire to maintain a sexual relationship with penetration, but physical reality is very different. There then appears a contradiction between the inexplicable mind-body for the person.


The result is an overwhelming sense of lack of control and an explosive increase in anxiety. Among the factors that can cause Vaginismus we find beliefs and values ​​of a sexual nature 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 in the first menstruation stage when wanting to introduce a tampon, irrational ideas about the penetration or the possibility of becoming pregnant and, even, distorted ideas regarding the perception of their own genitals.

And in the case of the 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 relations after surgery or delivery, genital irritation by soaps, allergies to diaphragm latex or condoms, and those aspects specifically of a medical nature (phimosis, frenulum, prostatitis, hemorrhoids, genital herpes, etc.).


We want to emphasize that, in the case of this dysfunction, the pain must be constant and repeated in sexual relationships ; Occasional pain does not mean there is a problem. Be that as it may, there is no doubt that discomforts greatly affect sexuality and can lead to the avoidance of relationships.

For this reason, in case of doubt, it is advisable to consult a professional.

Do people who suffer Vaginismus or Dyspareunia talk about their problem?

Most do not, they make it a taboo subject. In the case of women with Vaginismus, educational work is especially important. Lack of awareness about one's own body (there is usually no exploration) and social censorship, make the expression and normalization of aspects of a sexual nature even more difficult .

This reality moves the affected one away from the different contexts (friends, colleagues, relatives, etc.) for fear of being misunderstood and labeled as "rare". Fear increases day by day and alertness becomes an intrinsic element of 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 from a context of individual therapy, the work that is carried out from the couple therapy is important. To solve the problem it is essential to establish an open communication in order to express the discomfort and find mutual understanding.

Likewise, the therapeutic work that facilitates the change will be aimed at tackling, in a progressive way, 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 (eg, history of sexual abuse, abuse, or rape), will be some of the issues that, from a systemic and integrating 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 the lack of control contaminates the rest of personal contexts. The discomfort crosses the purely sexual frontier and translates into a fear that goes much further.

The inability to have sex with penetration still feel the desire , little by little diminishes the ability to seek pleasure and satisfy one's needs. Putting aside this problem can have a serious impact on a woman's self-esteem. Fear translates into more fear; that 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 couple psychotherapy is what will facilitate the person to recover self-confidence and, above all, not to live in a continuous struggle, thus getting control of the situation and stop " escape".

In this sense, the communication of couple is essential to reaffirm the right to express and empty all that accumulation of feelings that, unconsciously, one day were reflected in an essential organ.

Similar Articles