What causes painful sex and how can it affect your marriage?
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What causes painful sexual practice and how tin it bear upon your marriage?
In the second part of CNA Women's series on painful sexual activity, we await at the psychology behind vaginismus and how the fear and feet can strain – and sometimes break apart – romantic relationships.
Severe vaginismus cases tin can lead to the non-consummation of marriage, experts say. (Photo: iStock/Rawpixel)
For some, sexual activity is a pleasurable feel that deepens the bond between two people. Just for others, it is excruciating – and in more than ways than one. Why?
In that location are typically 2 weather condition that chronicle to painful sexual intercourse: Vaginismus and dyspareunia.
Women who endure from vaginismus are unable to tolerate whatsoever class of vaginal penetration due to pain, including medical procedures such equally Pap smears. This makes sexual activity "entirely not possible", said Dr Kelly Loi, an obstetrician and gynaecologist at Mount Elizabeth Fertility Middle.
In fact, for patients with severe vaginismus, even the thought of a pelvic examination may cause them to experience palpitations, trembling and nausea, she said.
"With dyspareunia, sex is possible but painful and uncomfortable," Dr Loi added.
Partly because of the "difficulties in distinguishing between the two conditions in clinical exercise", both conditions are now classified under 1 category – genito-pelvic hurting/penetration disorder (GPPPD), said Dr Tan Tse Yeun, a consultant at KK Women's and Children's Hospital (KKH) Department of Reproductive Medicine.
Typically, the cause of dyspareunia is vaginismus, which is said to be the about common form of female sexual dysfunction among its patients.
Only earlier that is determined, doctors volition beginning eliminate other possible causes, which may include "infections, inflammatory skin weather, neurological causes, hormonal causes and even structural causes that affect the female genital organisation", said Dr Grace Huang, a general practitioner at DTAP Clinic, whose work is focused on women'due south and sexual health.
For many women, what causes vaginismus and ultimately, dyspareunia, is an "intense fear of and anxiety about hurting before or during vaginal penetration", said Dr Tan.
"When women anticipate that hurting will recur during penetration, their vaginal muscles tighten, making subsequent attempts at sexual intercourse even more painful, resulting in a vicious cycle of pain and worsening fright," she said.
And what causes this fear?
The root cause may differ betwixt individuals, said Dr Huang. "Often, an individual's subjective sexual experience, thoughts, emotions and behaviour play a role in contributing to her difficulties."
For some women, the anxiety comes from by emotional or sexual abuse, or physical trauma such as a bad childbirth experience, said Dr Loi.
"Very often, however, there is no explanation," she said.
Nonetheless the whole feel is "very distressing", said Dr Huang, adding that in severe cases, information technology can lead to the non-consummation of matrimony.
"THE GUILT HAD ACCUMULATED And then MUCH"
This was the reality for 2 individuals CNA Women spoke to.
Kim (not her real proper name) was unable to consummate her marriage at outset as she continuously experienced pain during sex.
"I don't think I coped well. I felt not bad pain and feet during sexual intercourse, and then even though we tried a few times, we were non successful," she told CNA Women.
Several months into her matrimony in 2018, the 30-year-old administrator consulted a gynaecologist at KKH about her irregular periods.
The doctor wanted to perform a Pap smear and vaginal ultrasound as part of the investigations on her condition, but Kim was unable to get through with the procedures due to "swell pain, fear and stress", said Cheong Xinyi, principal psychologist with KKH'south psychology service.
After that year, Kim was diagnosed with vaginismus, attributed to "sexual naivety and inexperience with processes of sexual intimacy due to a conservative upbringing", said Cheong.
The diagnosis was disruptive at offset, Kim said.
"I didn't quite understand it since it was non a commonly known status. Even though I was very fearful, I knew that for the sake of myself and my family, I needed to resolve this issue so I gathered my courage and agreed to be referred to the Sexual Health Dispensary," she said.
The Sexual Health Clinic, which is operated under the KKH Women's Health and Wellness Centre, is said to provide the only multidisciplinary care service in Singapore for women with sexual dysfunction conditions. It adopted this multidisciplinary approach, which harnesses the expertise and support of various specialists including physicians, psychologists and physiotherapists, in 2015.
Kim said she visited the clinic monthly for virtually v months and met with various specialists who worked with her on different aspects of her condition.
"The initial menstruation is the well-nigh challenging period … For the kickoff three months, I was afraid of the desensitisation exercises (such equally gradual digital penetration). I was very broken-hearted whenever I practised and also could not practise consistently at home. So there was not much improvement," Kim told CNA Women.
Simply over time and subsequently regular sessions with the care team, Kim started increasing her habitation exercises, which she did with her husband, and used emotion regulation tips from her psychologist to manage her fear and anxiety.
"Later on repeated practices, I started to build ease with the exercises leading to an increment in confidence in tolerating an object in my vagina. The increment in conviction and seeing some achievement or success helped to farther reduce the fearfulness and anxiety," she said.
Kim eventually consummated her marriage in November 2018. Two years subsequently, she and her married man had a babe boy.
"I'm really happy and glad that I made the right choice to consult the professionals," said Kim, calculation that previously, gynaecology consultations made her "feel terrible" because doctors would show their "impatience and attitude" towards her inability to tolerate insertion tests.
In contrast, the specialists at KKH were "very prissy and patient". "They did non look downward on my trouble and fabricated me very comfortable. They allowed me to perform the therapy at my own comfort level and pace," said Kim.
For Puva, who just wanted to be known by her start proper name, the journey to recovery was much longer and more arduous.
The 39-year-onetime administrator married when she was 27 and divorced 7 years later after repeated unsuccessful attempts to have sex.
The couple had sought ways to improve their relationship, including getting a dog together.
"We thought that getting a 'pet baby' would improve our bond and our human relationship, but alas, it did not work as well," she told CNA Women.
One year into her union, Puva sought medical attention at KKH for recurrent fibroids. Like Kim, she was unable to go through with the medical examinations and was diagnosed with vaginismus.
She returned to KKH with her husband. At the time, KKH did non all the same provide a one-terminate multidisciplinary service for female sexual dysfunction and the couple consulted with an obstetrician and gynaecologist.
"After the first ii sessions, my married man felt that he did non need another male to teach him nearly sexual matters. He felt the treatment was not benefiting him and he gave it up. Without my husband, I likewise did not go on with the treatment," she said.
Their wedlock "finally bankrupt down" and the couple went their divide ways later on vii years together.
"I requested for a divorce as I could not endure it anymore. The guilt had accumulated so much and we were just not in adept relations anymore.
"When I offered to function ways, I could tell he was relieved and in a manner, information technology was my fashion of making it up to him," Puva said.
Afterward the divorce, Puva returned to KKH in 2017, which by now had a Sexual Wellness Clinic that was being managed by a multidisciplinary squad.
That was a "turning signal", said Puva.
"I found out that a lot of my fear and the pain I felt were due to the conservative background that I was brought upwards in. I felt similar I had rediscovered myself and really got to know myself in all aspects."
Puva eventually met someone new and finally had sex at the historic period of 37. She now has a son.
"Having a child has been my dream … After 10 long years, I finally got to hold a baby in my arms and now sympathise how enjoyable sex tin be – it demand not exist painful, full of fear and anxiety every bit what I had initially experienced.
"Getting treated was truly a life-irresolute experience," she said.
"DON'T BE AFRAID"
Both Kim and Puva urged other women to take activity if they are having issues in the bedroom, despite their fears of doing then in the typically conservative Asian social club.
Puva said there is "definitely a stigma with women trying to seek help with sexual health", which was why she "gathered courage" to share her story and experience.
"In Singapore, a bourgeois upbringing like mine is mutual. Hence it is difficult for me to even share these challenges with anyone shut to me … Until now, my parents still do not understand my condition well and do not believe that such a status exists," she said.
Despite this, she encouraged her peers "not to sit on it or procrastinate" if they suspect a trouble.
"Don't be afraid of being judged or looked at in a different light," she said.
"I regret not seeking handling earlier, otherwise I would non exist then tired now, trying to run after my toddler and keeping upwardly with his activeness. Only of class, meliorate late than never!" Puva added.
CNA Women is a new department on CNA Lifestyle that seeks to inform, empower and inspire the mod adult female. If you have women-related news, issues and ideas to share with u.s., email CNAWomen [at] mediacorp.com.sg .
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Source: https://cnalifestyle.channelnewsasia.com/women/painful-sex-causes-dyspareunia-vaginismus-psychological-fear-286157
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