Sexual health is an important aspect of human life, encompassing physical, emotional, and psychological components. However, amidst the societal openness about sex, there exists a significant issue that often remains in the shadows: the fear of having sex. While sexual intimacy is commonly portrayed as natural and effortless, for many individuals, the prospect of engaging in sexual activity can evoke profound anxiety and distress. This fear, often overlooked and misunderstood, is known as vaginismus. Another entity with similar symptoms is called Dyspareunia. It refers to painful intercourse secondary to conditions like endometriosis, vaginal atrophy etc. However, it is not associated with symptoms of anxiety or excessive vaginal tightness as seen in vaginismus. 

Vaginismus, regarded as female sexual dysfunction, is characterized by the involuntary contraction of the muscles around the opening of the vagina. This reflexive tightening can make penetration painful or even impossible, causing significant distress and anxiety for individuals attempting intercourse. While the exact cause of vaginismus can vary, psychological factors, past trauma, anxiety, or even vaginal infection or dryness contribute to its onset. This condition can result in a deep-seated fear of attempting intercourse, leading to avoidance of sexual activity altogether. However, it does not affect your ability to get sexually aroused.

Individuals experiencing this fear may feel isolated or ashamed due to societal expectations surrounding sexual activity. However, seeking support from healthcare professionals, including fertility experts and therapists specializing in sexual health, can offer a path towards resolution. The Goal is to change your feelings about your body and enjoy the entire act of intercourse.

Treatment for conditions like vaginismus and dyspareunia often involves a multidisciplinary approach. This may include physical therapy, counselling, education, and sometimes medical interventions to address underlying causes or alleviate symptoms. Use of vaginal dilators helps women to gradually become accustomed to subsequent sexual intercourse.

It’s important to recognize that the fear of having sex is not uncommon and can be addressed effectively with the right support and guidance. By acknowledging this fear from a medical perspective, individuals can find reassurance, understanding, and the necessary resources to navigate these challenges and rediscover a fulfilling and comfortable sexual life. Seeking professional help is a crucial step towards reclaiming confidence and intimacy, paving the way for a healthier and more gratifying sexual experience.

• Adequate foreplay and gentle finger dilation can help you reduce your anxiety. 
• Using Botox to relieve the pelvic muscle spasm can also go a long way in relieving vaginismus.
• Rest be assured, when you first visit your gynaecologist for vaginismus, it is highly unlikely that they will need to perform an internal examination.
• You can come in with your partner in order to help you enhance your sexual health, as a couple. Creating a safe and supportive environment for individuals to discuss their concerns openly is essential in overcoming the fear associated with sexual activity
• Psychosexual therapy is another approach to help you embrace your fears.

In Frame: Dr. Duru Shah, Director – Gynaecworld

By: Dr. Duru Shah, Director – Gynaecworld