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Painful sex and vaginismus
Two of the most common things women live with for years without mentioning to anyone.
I want to say this plainly, because it is the thing that stops people booking: this is an ordinary medical complaint, I hear it often, and there is nothing about it that will embarrass either of us. If saying it out loud is hard, write it down and hand me the paper. Patients do that and it works perfectly well.
Dyspareunia
Pain during or after sex has causes that are findable — infection, hormonal change and vaginal dryness, endometriosis, scarring after childbirth or surgery, or pelvic floor muscle overactivity. Where the pain is deep rather than at the entrance, that points somewhere different again. The assessment is a history and an examination, done gently and stopped whenever you want it stopped.
Vaginismus
Involuntary tightening of the vaginal muscles that makes penetration difficult or impossible. It is not something you are doing on purpose and it is not a failure of will — the body has learned to brace and keeps bracing. Causes include anxiety, previous painful or negative experiences, infection and chronic pain.
Treatment
There is more than one effective route, and which one fits depends on what is driving it: cognitive behavioural therapy where anxiety is significant, gradual manual dilation, botulinum toxin injection to relax the muscle, and surgery in a small minority of cases. Most women improve.
Risks and what to expect
Treatment depends on the cause. Botulinum toxin injection carries risks of bruising, temporary weakness and, rarely, difficulty passing urine. Where surgery is considered, its risks are explained separately.
Every procedure carries risk, and the risks that matter most depend on you — your history, your anatomy and your general health. They will be explained to you in full, in writing, before you are asked to consent to anything.
Any recovery times given here are typical rather than guaranteed, and outcomes vary from one person to another.
Every case is different, and what is right for one woman is not right for another. The purpose of a first appointment is to work out which applies to you. Arrange a consultation.
The information on this site reflects current international best practice and peer-reviewed literature, together with Dr Sharma’s own clinical experience. It is general information, not advice for your own situation, and is not a substitute for a consultation.
Talk it through
A consultation is a conversation first. Nothing is booked in until you want it to be.