Patient's question:
Hello! How can I overcome sexual intercourse fear? I have been married for nearly two months, but because I am afraid of pain and bleeding during intercourse, every time my husband touches the vaginal opening, I get scared and retreat. A doctor suggested that I should be put under anesthesia to complete my first time. Is this method acceptable?Doctor's answer:
(1) Knowledge Acquisition Method: Many women's sexual fear stems from a lack of sexual knowledge. As some scholars have said, "Ignorance and anxiety breed fear, while knowledge and assurance reject fear." Therefore, couples should read books on sexual knowledge together to understand women's sexual psychology, sexual responses, and other physiological and psychological aspects.(2) Attention Shift Method: Transferring one's attention away from the fear object is an effective way to eliminate sexual fear. For example, during the first sexual encounter, if the woman is timid and fearful, the man should show extra care and tenderness, caress her gently, and communicate with her, gradually stimulating her sexual desire. When she can no longer suppress her sexual impulse, the sexual act can proceed step by step, and the fear will naturally vanish.
One day in the sexual medicine consultation department of a gynecology clinic, I received a visit from a woman named Zhang, aged 30, accompanied by her husband, Xiao Zheng. According to the schedule, it was her turn, but she let other patients finish first before slowly approaching the doctor to share her unpleasant medical history. The consultation began with the chief complaint of "three years of infertility." She said, "I've been married for three years, living together with my husband, but for some reason, we haven't been able to conceive." I asked, "Have you both sought medical help or undergone any examinations in the past three years?" After a moment of thought, she replied, "I've seen a gynecologist, and they said my uterus is of normal size and there are no pelvic inflammatory issues. My menstrual cycle is regular, and the doctor concluded that the examination results were normal. My husband's semen analysis was also normal, and the doctor couldn't find any reason for infertility. After that, I didn't seek medical help again. Recently, my neighbor told me about a sexual medicine consultation clinic that specializes in addressing women's issues in this area, and I heard it's quite effective, so we decided to take the day off and come together today."
At this point, I privately considered that in the clinic, infertility with no clear cause could either be due to "immune infertility" or some hidden issue in their sexual life. So, I asked directly, "Is your sexual life normal?" At this question, Zhang's face flushed, and Xiao Zheng, standing beside her, also looked a bit embarrassed. They were speechless for a moment, unsure how to answer, but finally, Zhang blushed and stammered, "Three years ago... on our wedding night, after the guests left the newlyweds' room one by one, we were about to snuggle together. But I'm a highly sensitive person and have a low pain threshold. The moment my husband touched me, I became tense, my legs clenched, and my limbs trembled, so we couldn't consummate the marriage. When my husband touched me out of concern, I trembled as if I'd been electrocuted. On the second night of our wedding, not only did it not improve, but it became even worse. From then on, every night, I'd turn my back to the wall, face the wall, and wrap myself in a towel... letting the precious moments slip away. My husband had no choice but to give up, and he felt too ashamed to consult a doctor about such private matters. This went on for three years."
At this point, Xiao Zheng chimed in, "This isn't Zhang's fault—it's mine. I was ignorant and had no one to guide me, so we wasted years of precious time..." After hearing their story, I conducted a check and found that Zhang's hymen was intact. It turned out that Zhang suffered from "sexual intercourse phobia." So, I gave them an additional lesson in sexual medicine, explaining the basics of sexual life to them, helping Zhang overcome her concerns, and introducing suggestive therapy: I brought a set of sterilized cervical dilators from the clinic's minor surgery room and demonstrated their use to Xiao Zheng. I told him to use a sterilized, glycerin-coated cervical dilator to gently stretch the hymen opening once a day, starting with a smaller size and gradually moving to larger ones. When the dilator enters the vagina without causing pain to Zhang, her fear of intercourse would naturally disappear.
After returning home and using this method for a short time, Xiao Zheng came to the hospital and told me, "Our sexual life has succeeded!" Two months later, both Xiao Zheng and Zhang came to me with the good news that Zhang was pregnant. The following year, Zhang gave birth to a healthy, chubby baby.
Zhang's "sexual intercourse phobia" is medically known as "vaginismus," which is primarily caused by psychological factors and is more common in highly sensitive women. Newlyweds with a lack of sexual knowledge and excessive fear of sex may become overly tense and fearful during intercourse, leading to vaginismus and failure to consummate the marriage on their wedding night. This condition can also be caused by local factors and sexual factors, such as an overly rigid hymen, which can cause severe pain during the first sexual encounter; conditions like urethral papilloma, Bartholin glanditis, perineal ulcers, or hymenitis, which can cause pain during intercourse and trigger defensive reflexes; or rough behavior from the male partner during the first sexual encounter, which can cause intense pain when the hymen tears and lead to vaginismus.
The primary treatment for this condition is psychological therapy, which involves educating the patient about sexual knowledge and alleviating their concerns. Suggestive therapy can also be used as an auxiliary treatment, such as the method mentioned earlier with cervical dilators, which not only helps the woman gradually adapt but also allows for a step-by-step process of overcoming fears and building confidence. If a cervical dilator is not available, the finger dilation method can also be used. This involves the doctor or the husband wearing a sterilized rubber glove, applying lubricant, and gently inserting one finger into the vagina at first, gradually extending it. After success, a second finger can be added. When both fingers are inserted without pain or discomfort, the patient is told they can begin trying sexual intercourse. During intercourse, the penis should be inserted gradually, without discomfort, and eventually fully inserted, leading to a natural conclusion. For highly sensitive patients, a small amount of sedative medication can be used as an aid; applying 10% cocaine cream before intercourse can also reduce local pain. Additionally, it's important to improve sexual techniques, caress the woman gently, and be gentle during intercourse. If the woman has vaginal inflammation, she should receive systemic treatment first and only resume intercourse after recovery.
Xiao Zheng and Zhang, as newlyweds, were both "sexually blind," knowing nothing about sexual knowledge. Coupled with feudal influences and a reluctance to speak openly, they failed to seek medical advice in time, leading them down the wrong path and wasting three years of precious married life, as well as missing their "optimal fertility window." How many newlywed couples like Xiao Zheng and Zhang are there in China? Reports indicate that some newlyweds have even divorced due to unresolved "sexual intercourse phobia."
From this, it's clear how important and necessary premarital sexual education is!