Problems with Sex for Pregnancy

Mary M Buxton LCSW, Inc.
AASECT Certified Sex Therapist

Each year, many young Indian women get married and move to Silicon Valley.  Mrs. Patel (fictitious name) has been married one year. Each time she and her husband tried to have intercourse, they could not. They did find creative ways to pleasure one another in spite of this barrier. 

Sex education is very often a subject that is not mentioned in Indian families. Many families believe that the couple will learn through trial and error “when the time comes.”

However, community pressures to have a baby started to build about one year after marriage.   Together the couple had conquered adjustment to marriage, new extended family relationships, and life in the US. But the problem they were having was private and they did not know where to turn for help.  The more friends of the same age got pregnant, the worse they felt.  They were ashamed and weary of feeling embarrassed and inadequate when answering well meaning questions from friends and family like, “When are you going to start a family?” or  “and when will we get grandchildren?”.  Over time they started withdrawing from family and friends and living isolated with their “problem”.  At her yearly medical appointment, Mrs. Patel's OBGYN diagnosed the problem as vaginismus and referred them for couple sex therapy.  This was how they learned to solve their problem, regain their confidence and rejoin their social world. 

This is a typical story for couples who have been raised with little information, instruction or comfort with sexuality education. Sex education is very often a subject that is not mentioned in Indian families. Many families believe that the couple will learn through trial and error “when the time comes”.  Cultural inhibition as well as the stress of adjusting to a new culture may make it more difficult to discuss sexual issues.  This one story of many.  Pieces of it may reflect part or all of someone else’s struggle with  vaginismus. 
Vaginismus is an involuntary spasm of the “pc” or pubococcogyeal muscle at the opening of the vagina. If there is pressure to penetrate against this tight muscle, it can also cause physical discomfort and more tightening. Other muscles in the pelvic, abdomen, thighs and abdomen may tighten up as well. There are also other conditions that can cause painful penetration. In the U.S ., 15% of women have issues with painful sexual intercourse.  If you tell your OBGYN that you are having difficult entry during intercourse and / or painful penetration, they will know what to look for when they do the exam. This can help clarify if there is a problem in addition to tense muscles that might need medical treatment.

Vaginismus can be caused by a number of factors.

  • Lack of sex education and cultural inhibition about sexuality
  • Chronically tight muscles in the pelvic floor.
  • Sexual anxiety that the vagina is too small, of penetration will hurt.
  • Aversion to and avoidance of anything sexual.
  • Sexual trauma like sexual abuse or rape.

The treatment often involves a multidisciplinary approach.  The medical doctor diagnoses the condition and usually refers the patient to a sexual therapist.  A sex therapist is a licensed clinician specializing in solving sexual concerns.  During the first session, the practitioner should listen with sympathy and understanding and assess the specifics of the problem.  You will have homework assignments and subsequent visits focus on the steps for treating the problem. There is a specialized form of pelvic floor physical therapy that can also be of great benefit and help progress occur at a faster pace. Each person moves at their own pace depending on their level of comfort.  The length of treatment can vary but is usually considered brief treatment.  Consistent practice usually brings good results.  

If you are suffering from a sexual problem, you are not alone.  Fear, embarrassment and not knowing that help is readily available, often keep people stuck without a solution to their problem.

Updated 7/11/11


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Mary M Buxton LCSW, Inc. - Sex & Couple Therapy - Licensed Clinical Social Worker  #LCS 7780
15951 Los Gatos Blvd., #14, Los Gatos, CA 95032 -  Phone: 408.371.4847 -  Email Mary

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