Closed Passage

Ram is perplexed. His wife Ramya seems to thoroughly enjoy foreplay, but when he tries to enter her, she tenses all over, closes her thighs, grits her teeth and clutches her pillow tightly. The ‘No Entry’ sign seems permanent, and when he expresses his frustration, all she does is dissolve into tears.

Ramya’s condition is called ‘Vaginismus.’ It’s an involuntary, instinctive contraction of the vaginal muscles in anticipation of pain, either real or imagined, thereby preventing penetration by the man.

The condition may be developed not only by new brides but long-married women too. In the former, the cause may be psychological, brought on by gory tales told by friends and relatives of pain on the first night, trauma of child sexual abuse, religious orthodoxy etc. But it can also occur after a period of sexually active life, largely due to physical causes. These include infection or injury to the genitals, fear of pain or discomfort post childbirth, post-uterine surgery, hormonal conditions like endometriosis, lower bowel disease, hip arthritis, etc.

The man’s reaction when confronted with this problem is usually frustration and anger, and the ‘frigid’ tag is foisted on the woman all too often. The woman on her part feels frightened and humiliated. Her self-esteem takes a dip, feelings of inadequacy and insecurity settle in, compounding fear of rejection. There may be complete breakdown in communications between the couple. It may give rise to an intense mutual blame game, ending all too often in breakup. A key fallout of this situation is infertility, as intravaginal deposition of semen does not take place.

Sex therapy is the treatment of choice to overcome this problem. The therapist, after a thorough physical examination, followed by an analytical interpretation, prescribes a series of sexual exercises designed to remove apprehension. With time, patience and perseverance, the couple gradually learn to break down the barriers and consummate their relationship, once the woman is convinced that her fears are unfounded.

The writer is a sexologist. Mail him at dr.narayana@deccanmail.com