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    My name is Marianne, and I’m the co-author of a well known book on sex education for teens in Switzerland. The book is widely used in schools and supported by several official health organisations.

    One of the chapters talks about pain during sex, and vaginismus is treated extensively in there, mainly under my influence because I think it’s a very important topic. In a recent update of the book, I’ve used a few testimonials I found on this site and I want to take this occasion to thank you all for sharing your thoughts and ideas on such an intimate subject. Also a big shout out to the people at the Maze clinic to offer vaginismus patients a way to express their feelings.

    A few years ago we used a major part of our budget to launch an extensive survey among teens (both male and female!) on pain during sex. The results of this survey made us re-write a big part of the book.

    I’ve found a few posts referring to this on the forum, but it seems that in most European countries, pain during sex is actually very, very common during the first few times teens have sex. Our survey showed that a whopping 92% of all women reported pain during at least the five first times they were penetrated by their partner. As far as I know this is not the same as in the States. A few people in here already talked about the difference, which is (in my opinion, I don’t have any proof for this) mainly due to the fact most teens don’t want or dare to insert objects into their vagina as long as they haven’t been sexually active. Tampons, cups or sponges are hardly used in the age group between 13-21. Masturbation is mostly done by stimulating the clitoris. This means that when couples have sex for the first time, it’s often also the first time something is inserted into the vaginal canal. Again, I have no proof to support this statement, but I’m pretty sure most women over here still have intact hymens when they get sexually active. This, together with a vagina that has never been stretched before, probably causes most of the pain.

    So the first thing we actually did was we DIDN’T tell them that pain was abnormal, but we turned things around and wrote that pain is to be expected the first few times they are going to have sex. And we added why and how the pain is caused. However, and it is important to stress this, we also said that when the pain doesn’t gradually diminish, there might be a problem. The initial feedback from the book we got after we re-wrote that chapter was very positive. Girls found it reassuring to know that pain can be expected, but only to a certain extend. That line, defining when pain during sex is normal and when not, wasn’t always that clear before.

    This might be a bit out of scope for this forum, but what struck us the most when we reviewed the results of the survey, is that males reported pain when they had sex for the first time as well. Over 97% of all males aren’t circumcised over here, and problems with tight foreskins are often discovered for the first time at this stage. In about 10% of all boys, the frenulum snapped while penetrating their partner. In some cases, men reported it to be painful when their penis ‘pushed’ against the ridges of the hymen in an attempt to enter the vagina. This is an aspect I think needs more attention, both during sex ed at schools as here on the forum.


    Thank you for bringing this up. I’m a male and I can confirm we can be in pain too during sex – in my case in particularly while I was trying to attempt to have intercourse with my wife (who has vaginismus). I’ll try to write something about that in the section for males, since I feel it doesn’t belong here.


    marianne – thank you SO much for all your work around educating teens in Europe about sex and their bodies. Speaking as an American who got abstinence-only sex education, the work you have done is so important and valuable for the health and education of young people.

    Even though I’m 5 years out from having received my botox procedure for my vaginismus, there’s still so much I’ve learned over the years since about the best ways to talk and educate about sex and pain and what’s “normal” and what normal even means, and it sounds to me from all my understanding that the way you’ve rewritten the chapter on sexual pain is about the best possible way there is to talk about the topic. Contextualizing the kind of pain that is to be expected for most women and ALSO setting clear and specific parameters around paying attention to when pain ISN’T diminishing seems like a tough line to walk and I’m really pleased to hear it’s gotten such a positive reception. I really hope that the way you’re educating people in your country becomes more prevalent all over the world, especially in places like the United States where this kind of information is sorely lacking.

    It’s really interesting that you identify the fact that BOYS often have pain in early intercourse as well. It makes sense when you think about that some teens might not know to use lube (or not use enough) and that so many of them are uncircumcised. Circumcision is way more prevalent in the states so I wonder how the statistics you’ve identified would compare here, but it’s amazing that you’re normalizing this kind of practical, applicable information so teens understand what to do and when to seek help if the pain isn’t lessening. So grateful there are people like you out there doing this work!!!

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