The HEALTH | SEPTEMBER, 2019
16
FERTILITY JOURNEY
Sex
shouldn’t
hurt, but
what if it
does?
It is a real issue, it is out there
and it needs to be addressed
S
EX is often considered a rite of pas-
sage for many people across many
culture, and everyone will experience
it sooner or later. However, when
sex does occur, and you experience
a burning or stinging pain instead
of the expected intimate connection you share
with your partner - it should be time to see the
doctor. A condition involving a muscle spasm
in the pelvic fl oor muscles, vaginismus makes
it painful, diffi cult, or impossible to have sexual
intercourse. Suwannee Pongprakyun, fertility
counsellor at KL Fertility dishes out details on
this condition.
Some do feel the pain
“Th e incidence of vaginismus is supposedly
to be about 1 to 17 per cent per year worldwide.
However, as a fertility counsellor, I usually
encounter an average of three to four vaginis-
mus patients each month,” explains Suwannee.
Often places a strain
on the relationship
According to Suwannee, couples with vaginis-
mus are capable of being physically intimate
and are able to maintain a loving, joyful and
harmonious relationship together.
“However, during the counselling session,
when the couple starts speaking about vagi-
nismus, tension may be observed as the lack
of sexual intimacy does potentially aff ect the
relationship. Especially when these couples
have the intention of producing children or
expanding their family,” she notes.
What goes on in
a counselling session?
“In our clinic, the patients would have a con-
sultation with our physicians fi rst. Th e doctor
will be able to diagnose vaginismus through
pelvic examination or if they notice penetra-
tion cannot be achieved when they attempt to
perform a transvaginal scan. Th e doctor may
also inquire about the patient’s medical and
sexual history, carefully taking note of key-
words such as ‘Our relationship has not been
consummated.’, ‘It hurts when we have sex.’,
and ‘we failed to have successful penetration’.”
Typically, vaginismus counselling would
consist of a lot of information gathering in
relations to:
• Th e couple’s sexual intercourse experience(s)
• The wife’s childhood experiences &
upbringing
• Th e wife’s history of trauma or abuse
• Th e wife’s views, thoughts and feelings
about sexual intercourse.
“A lot of focus will be placed on the wife
because vaginismus is a disorder purely expe-
rienced by women only,” explains Suwannee.
Treating vaginismus
“As a counselling psychologist, the fi rst form of
Suwannee,
fertility counsellor
at KL Fertility
believes that sex
education is key
to understand this
issue.
treatment for vaginismus is helping the woman
become more psychologically and physically
comfortable with sex. Th is is done through
behavioural reconditioning of the bodies
response to feared objects such as the penis, a
tampon, a speculum, a transvaginal scanning
probe or any other objects that is safe to be
inserted into the vagina.”
“Personally, I prefer using a systematic
desensitisation approach, whereby my female
patients will be asked to create a hierarchy of
the above feared objects that she will then
progressively work through to insert vaginally
over the course of treatment.”
Primary and secondary vaginismus
“Primary vaginismus occurs in women
who have never been able to have pain-free
intercourse and is believed to be caused by
psychological issues such as anxiety, fear of
pain, stress, traumatic events or childhood
experiences.”
“Secondary vaginismus on the other hand
is when a woman who has had successful
penetration, then develops vaginismus. Th is
may be due to physical causes such as a medical
condition, surgery, pelvic trauma, childbirth,
or menopause.”
According to Suwannee, the treatment for
both primary and secondary vaginismus is the
same.
Empathy and support is key
How can husbands and partners play a role to
help ease the pain?
“My advice is to do some research and
educate themselves on the matter in order to
understand the condition better. Second, learn
Brought to you by:
to empathise with the spouse. Th e symptoms
felt by the woman such as tightness or spasms
is not within her control.”
“Thirdly, be patient and supportive
especially during the treatment process. Th e
process of trying to overcome vaginismus can
be frustrating. Knowing that they have the
husbands support and that they are not alone
can make a diff erence in their progress towards
recovery. — Th e Health
When
love hurts
THIS is the story of Emma, a
35-year-old with her husband , who
is 36. They have been married for 10
years. The couple has been trying
to conceive for fi ve years. However,
she was unable to consummate
the marriage. “Every time we
tried to have sex, it was like there
was a block that wouldn’t allow
penetration and it was very painful.
I opened up to my best friend who
told me she had just started seeing
a fertility expert. I wasted no time in
scheduling an appointment.”
The doctor not only diagnosed
that Emma had vaginismus, but
told her it could actually be treated.
“I began undergoing medical
massages and a few treatments
later, I was asked to have sex. I was
so happy to say that the treatment
worked!”
The couple was ecstatic about
their new found joy in marriage, and
after one and a half years of treatment
and a change in lifestyle – Emma
discovered she was pregnant. “Sadly
I suffered a miscarriage but my doctor
was very supportive and reassured
me to try again.” The couple prayed
for another and was given new hope
later on. “I missed my period – the
doctor confi rmed the pregnancy but
I was extra cautious this time. Our
second time trying was a success,
and our son was born safely on
October 14.”
“My advice to couples out there is
to never give up and keep looking for
answer. Don’t be embarrassed and
feel like something is ‘wrong’ with
you. Support from your family, friends
and spouse are also crucial,” Emma
advises.