DEAR TEND: You ask us your sexual wellness-related questions. We get sex therapist Dr. Terri St. George to answer them.
Tend: What do I do if my anxiety is physically preventing me from having sex? Terri St. George: Without doing a full assessment, it sounds like what we might be looking at is a condition called vaginismus. Vaginismus is a relatively common condition [in people with vaginas] involving involuntary contraction and tightening of the pelvic floor muscles in anticipation of sex (vaginal penetration). This involuntary reaction occurs if penetration is perceived as or expected to be painful or scary or risky. Fears (sometimes unconscious) of sex being painful, fears of your vagina being too small or whether or not you can “fit” a penis, fears of STD’s or pregnancy, religious or cultural internal conflicts, all can lead to this condition. Often [people] with vaginismus also describe being unable to use tampons, have a GYN exam, and even insert their own finger into their vaginas. It can feel painful or it can feel tight and closed up, like you’re hitting a brick wall. The good news is that vaginismus is totally treatable. With the right help and support (GYN, pelvic floor physical therapist, sex therapist), you can learn to relax those pelvic floor muscles and enjoy sex (intercourse), if this is something you want. It might also be helpful to consider intercourse as just one menu item in a full, satisfying meal. If you can expand your idea of what “sex” is, you can enjoy all the other things you can do (solo or with a partner) to have pleasure and connection.
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