We want to preface our response to this question with the reminder that neither of us are medical professionals of any kind. All of our ideas should be taken as suggestions of things to read more about on your own and/or to bring up to your doctor rather than actual diagnoses.
Q: I have been married for 11 years. When we started dating, my husband was a virgin, and I was a virgin with men, but had been in a relationship with a woman before him. We were in a long distance relationship for two years before we got married. I had tried to have sex with one man before my husband, without success. His penis just would not go in, no matter how much lube, foreplay, etc. we tried. The first time my husband and I had sex, we were successful, although there was some pain, which I was expecting since the popular perception is that a woman’s first time is painful.
Once we were married, sex never got any easier. Insertion was always difficult and there was always pain, no matter what we did. He could never last very long, either, so basically the whole situation was frustrating and unsatisfying for both of us. I asked my gynecologist about it a few times, but all she would recommend was a sex therapist (which I knew my husband would never agree to).
We ended up never having sex – I would give him oral and he would get me off manually. We would try sex every once in a while, but it never worked out. I was diagnosed with PCOS a few years ago, and I have been told that that condition can cause sex to be painful, so I don’t know if that’s perhaps what was contributing to our sex problems. I’m also no longer taking hormonal birth control (I have an IUD) and that has helped with dryness and sex drive. Now I want sex more, and he has no sex drive at all. He says it “doesn’t work” anymore, and isn’t willing to go to the doctor to have himself looked at.
Basically, we’re a hot mess. Is it possible for my vagina to be too small? Everyone says no, since a baby can come out of it, but honestly, that’s what it feels like. Even if everything stretched right, he never lasted long, and now he says he can’t get hard and isn’t interested in doing anything. Is there any hope for us, or are we doomed to continue on in a sexless marriage (as we have been for at least the last four or more years)
First, there can be many reasons that penetration may hurt, and identifying exactly what the problem is can be the first step toward solving it. One possibility (fairly unlikely in your case, from what we’ve read, but still possible) is that your hymen may be getting in the way. Hymen thickness and durability, for lack of a better word, can vary widely, and it is quite possible for parts of the hymen to remain stubbornly intact through all different kinds of sexual activity. This page from the Center for Young Women’s Health has some pictures of different hymen shapes and discusses how certain types of hymens can obstruct penetration and menstrual blood flow.
Another reason that intercourse may hurt is endometriosis, which is when tissue growth like the kind that takes place in the uterus starts happening other places, like outside of the uterus or on the ovaries. One of the symptoms of endometriosis is pain during or after intercourse; other symptoms include painful periods and pain or cramping before and during your period. We don’t know how having PCOS might affect a person’s experiences of endometriosis symptoms (plus, you can have pain and cramping during and after your period for other reasons), and so if you think this might be a possibility, we would mention it to your gynecologist.
What seems like the most plausible possibility to us is vulvodynia or vaginismus. According to the National Vulvodynia Association, vulvodynia is simply chronic vulvar pain with no identifiable cause. They describe two subtypes of this, generalized vulvodynia (which is spontaneous and often constant pain and which does not sound like what you’re describing), and vulvar vestibulitis syndrome, which according to the NVA “is characterized by pain limited to the vestibule, the area surrounding the opening of the vagina. It occurs during or after pressure is applied to the vestibule, e.g., with sexual intercourse, tampon insertion, a gynecologic examination, prolonged sitting and/or wearing fitted pants.”
From what we have read about vaginismus, this sounds the closest to what you have described. According to vaginismus.com, an informational site created by a couple who has struggled with it for almost 20 years, vaginismus is “vaginal tightness causing discomfort, burning, pain, penetration problems, or complete inability to have intercourse,” and symptoms include burning and stinging during sex and difficult or even impossible penetration. The page we’ve linked you to discusses common experiences and quotes from women who have vaginismus. Both vulvodynia and vaginismus are very frequently misdiagnosed or missed completely, and the personal accounts that paperispatient has read from women who were diagnosed with vaginismus almost always involve doctors who are unfamiliar with the condition. This is absolutely worth reading more about and mentioning to your doctor, or perhaps to a different doctor if yours just suggests the same thing over and over. Both of these posts from the Good Vibrations blog involve women having similar experiences and the authors offer some suggestions of things they can do on their own to try to make penetration easier.
Is your husband not interested just in trying to have intercourse, or is he uninterested in any sexual activity at all? Although there can be a range of reasons behind a man being unable to get hard, from what you’ve said this sounds more mental or psychological. Do you think it’s possible that he blames himself for causing you pain? If you haven’t talked about this, it may be worth bringing up – if he feels badly for hurting you and associates sex with causing you discomfort, it’s understandable why he doesn’t feel interested in it.
(Also, this seems like a good time to mention: it doesn’t sound as if you blame yourself at all for this, which is really great to hear. Some of the personal accounts from women with vaginismus that paperispatient has read involve the woman blaming herself and feeling like it’s her fault or she’s not trying hard enough, and although we didn’t get a sense of that in your letter, we wanted to make sure that you remember that neither you nor your husband should hold yourselves responsible for something your body is doing that is not in your control.)
Is he willing to help you enjoy yourself? Even if he’s not interested in being actively involved, him cuddling you while you masturbate could be a good “middle ground’ on which to start – there is no pressure or expectation for him to perform, and you get to do something sexual with your husband. You could also see if he would be interested in using toys with you, if that prospect interests you as well. Paperispatient has struggled with some problems that keep her from being able to have sex as frequently as she’d like, and she’s found that the longer she goes with no sexual activity of any kind, the more “dormant” her sex drive gets. Doing sexual things that let her lady parts rest but that please future Mr. paperispatient or that involve other parts of her body help her keep feeling sexual, and we wonder if the same may be true for your husband. The important thing to remember is that sex isn’t – and shouldn’t be – limited to intercourse; being unable to have a certain kind of sex doesn’t mean you’re not having sex at all. Presenting this perspective to your husband could be helpful as well, as it’s possible that he feels there’s no point in doing anything sexual if it can’t culminate in what we’ve been told is the be-all and end-all of sexual activity.
From your letter, we think these different issues – painful penetration and your husband’s loss of interest in sex – are related, and we hope that figuring out the cause behind the former may help with the latter. This was definitely a complex question, and we hope we’ve been able to offer some helpful suggestions!