Leandie Buys Realtionship Therapist & Clinical Sexologist

Painful Intercourse

There are two conditions which describe painful intercourse: Vaginismus and Dyspareunia.


Vaginismus is defined as ‘vaginal tightness causing discomfort, burning pain, penetration problems, or the complete inability to have intercourse.

Between two and twenty percent of women are affected by this condition.

It and may leave the woman feeling sexually inadequate and less 'womanly'. This often leads to serious problems in their relationships.

There are several types of vaginismus:

Primary vaginismus is diagnosed when a woman has never been able to have pain-free intercourse due to severe muscle spasms. These women are often unable to wear tampons and/or complete pelvic exams. The sexologist will treat this condition by helping the woman overcome negative attitudes towards sex, as well as a negative or distorted body image.

Secondary vaginismus can develop later in life even if the individual has previously experienced pleasurable intercourse.

Secondary vaginismus is usually caused by a medical condition, a traumatic event, childbirth, surgery or life-changes such as menopause.

Treatment of vaginismus is very successful, and often results in a full recovery. Treatment does not require drugs, surgery, hypnosis or any other complex and invasive technique. The sexologist will design a programme which will help the woman overcome the cause of the vaginismus.

Causes may include incorrect childhood beliefs, past sexual violations and encounters and childbirth. If the cause of the problem is medical, the sexologist will work together with the woman’s GP.


Dyspareunia is a general term used to describe all types of pain experienced during sexual intercourse for both men and women. Vaginismus is one of several types of sexual pain.

Dyspareunia in women has a number of causes, including:

  • Allergic reactions 
    (to clothing, condoms, contraceptives,      
  • Bartholin’s cyst
  • Childbirth trauma
  • Endometriosis
  • Genital or pelvic tumours
  • Injury to pelvic area
  • Interstitial cystitis
  • Medication side-effects
  • Menopause
  • Ovarian cysts
  • Painful pelvic examination
  • Pelvic Inflammatory Disease (PID)
  • Radiation therapy
  • Skin conditions
  • Trauma due to sexual assault
  • Urinary tract infection
  • Vaginal atrophy
  • Vaginal dryness
  • Vaginal infections
  • Vulvar cancer
  • Vulvar vestibulitis

Dyspareunia is often found to be a trigger for secondary vaginismus.

For example, a woman might experience pain due to a vaginal infection, but the pain may continue once the infection is treated. This vaginismus is psychological and can be successfully treated by a qualified sexologist.

Dyspareunia in men may be caused by irritation of the penis skin due to an allergic rash and physical abnormalities of the penis.

  • “A very private pain” by Dr Rosie King
  • Dr. Carol Boulware, MFT, Ph.D. (www.psychotherapist.net)
  • www.vaginismus.com