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    Low sex drive tends to accompany vaginismus because the anticipation of pain makes it difficult to become aroused or interested. For a person who has not experienced that kind of pain, it is difficult to understand just how much it hurts, how anxious it makes you feel and just how uninteresting sex can become. Case in point: my husband. Whenever he suggests sex, I find myself getting extremely irritated. I get so annoyed that I yell at him sometimes- “Didn’t I tell you it HURTS? I bet you wouldn’t be so excited if you were the one in pain!!!” Some nights, I have become so upset by his attempts at arousal that I have gone to sleep in the next bedroom or on the couch because I don’t want to be touched. I’ve become a little paranoid about it too- sometimes my husband will give me a kiss or a hug, and even though he is not suggesting sex or trying to get me aroused, I feel as though he is, so I push him away or tell him to leave me alone. I realize it’s hard for him to grasp the fact that I don’t want to have sex, but it drives me crazy that he doesn’t understand that I’m in so much pain that I am not remotely interested. It’s taken my husband a long time to finally accept that my lack of sexual desire is related to the pain, and it is not because I don’t find him attractive or don’t think he is a good sexual partner.
    Has anyone else experienced something similar?

    Dr. Pacik

    It is fairly common to have a low libido as a result of vaginismus. When I study the returned questionnaires, I review this carefully. During my phone conversation I like to know if the libido was once good and did it suffer as a result of vaginismus. At times someone will tell me her libido was never very strong or even non-existent. This might be coupled with difficulty in achieving orgasm. In these instances one might expect little change after treatment and the need for professional sex counseling. On the other hand, women who have had strong libidos are likely to regain their sexual interests and desires once comfortable intercourse is achieved. Irritability is one of a host of emotions that surface as a result of the frustration that stems from vaginismus. Women with this feel stuck, no way out, no one to help them. They find themselves snapping, they go through depressions and many other emotions that they are unhappy with. Relationships suffer. It is for these couples that professional help is needed both before treatment and after treatment. This can take the form of sex therapy or couple’s counseling. I advise my patients to seek the help of a certified therapist.
    I will ask some of the therapists that I work with to comment on this very important post. All of these posts are important to help identify common problems related to vaginismus, to understand that you are not alone, you are not “the only one”, and that help is available.


    Peter requested that I respond to this post, as I am a clinical social worker and certified sex therapist who has experience treating people with sexual pain issues. One of the tragedies of sexual pain is the development of secondary relational and sexual problems such as phobic avoidance of sexual behavior, desire and arousal issues, as well as difficulty with how one experiences orgasm and pleasure.

    For the individual that struggles with sexual pain, there is often a sense of fear that any physical touch, or even intimate conversation, may lead to a sexual encounter and, not surprisingly, sexual pain. This fear may take on the guise of anger, sadness, resentment, and a variety of other emotional and physical symptoms that, initially, appear to be unrelated to sexual pain. Over time this may lead the person with sexual pain to feel like “damaged goods”, isolated from their partner, shamed, and hopeless that the situation will ever change. Many people who struggle with sexual also pain feel as if their bodies have turned against them, which can further add to struggles with ones sense of attractiveness and positive self regard compounding their desire to avoid sexual intimacy. For the partner that does not experience sexual pain there is often a lack of understanding about their partners’ pain resulting in confusion, rejection, frustration, and the perception that their partner no longer desires them.

    There is an old saying that the three things that people don’t discuss with potential partners are “money, kids and sex.” Many couples feel unprepared to discuss sexual pain issues openly with one another. Here are some tips for communicating effectively with your partner about sexual pain.

    Be prepared to share the following information with your partner; 1) where specifically the pain is located on, or in, your body, 2) the experience of the pain, e.g., burning, sharp, dull, stabbing, etc., and 3) the pains intensity level, e.g., on a scale ranging from one to five, where one is no pain and five represents excruciating pain, what level of do you experience during sex. Share with your partner how you feel this pain has impacted your sense of self and sexuality and ask how the absence of sex has impacted your partners’ sense of self and sexuality; discuss how the sexual pain has impacted your shared experience as a couple. This will also help both of you to begin working together to address the problem and can, for many couples, create a collaborative effort to begin looking for ways to address the problem together.

    There are many professionals who specialize in the treatment of sexual pain issues. Two resources that can be helpful in locating professional assistance in treating sexual pain issues are The American Association of Sexuality Educators, Counselors and Therapists, or AASECT, and The Society for Sex Therapy and Research. These organizations provide people with access to therapists who have extensive training and experience in treating a variety of sexuality difficulties, including sexual pain issues. There are multiple options to treat sexual pain issues that range from psychotherapy, behavioral exercises, mind body approaches, state of the art medical interventions, to integrated modalities that involve all of these approaches. There is no need to suffer the agony of sexual pain. Help is available for both of you!

    Joseph Winn MSW, LICSW, CST
    180 Massachusetts Avenue Suite 301
    Arlington, MA.
    P: (617) 461-8479

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