I want to have sex, but I know sex shouldn’t feel like this

I am a 20-year-old female, a recent professional graduate and have just started working in a really exciting role. I have loads of plans for the next few years. Life is generally very good. I get quite a bit of interest from men and have been on lots of dates, although I haven't had full sex in about four years. When I was 17 I lost my virginity and it was an awful experience. I did consent and was not forced in any way, but the foreplay seemed rough and he treated me afterwards like I was an object. Although not directly naming me, he made jokes about the experience on social media. Even thinking about it now makes me feel sick. It hasn't stopped me wanting to have sex and there are things that I can do. But when it comes to any form of penetration, it seems like my body seizes and I start to feel pain and we have to stop. Luckily, the men I have been with in the past few years have been really nice and patient and so far it hasn't stopped me completely from having relationships. The thing is, I really want to have sex, and I am worried that it might never happen again. I don't know if I was damaged in some way at the time I lost my virginity, but I know sex shouldn't feel like this.

What you are experiencing is vaginismus and this is a response by your body to protect you from harm. From what you say, it would appear that this response – of your body’s refusal to allow intercourse – is a psychological one, but it is still worthwhile having a full physical check-up to rule out any other issues. Vaginismus is an involuntary muscle spasm of the pelvic floor muscles that can occur during penetration. The tightening of the muscles – much like an eyelid closing to prevent something getting inside – is what causes the searing pain.

The muscle responsible for the involuntary contraction is the pubococcygeus muscle, which is responsible for urine control, contracting during orgasm and pushing a baby out. When you get an all-clear from your GP, it is worthwhile seeing a psychosexual psychotherapist and perhaps a chartered physiotherapist who can guide you through the healing process. This process often involves dilators and pelvic floor physiotherapy, as this gradually eases the tense muscles.

The psychological component of this issue can be related to strict religious upbringing, fear of pregnancy, past negative experiences or other internalised sexual messages. These can often be traced back to childhood or schooling years where traumatic negative messages were absorbed and the body reacts against intercourse.

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The first sexual experience is often a very difficult one where the focus is on performance and often the aim is to get through the ‘loss of virginity’ event rather than focus on closeness and pleasure. It seems you were treated to an experience of roughness and while you say there was consent, it does not sound enthusiastic, pleasurable or agreeable.

This is not the version of consent that is currently being discussed in student unions around the country and you can tell from your body’s response that it was not truly participatory. Your body is now blocking you from repeating this event as it deems it to have been too traumatic to replay. Even though your mind is positive about the possibility of sex, your body is very clear that it will not co-operate unless it feels completely safe and this may take some time to achieve.

Most men will be very understanding in their desire to help any partner overcome vaginismus and you are fortunate that you have already had this experience. However, it is likely that you and any future partner will both need some guidance as how to dissolve the blocks to the full sexual experience and with two people addressing the problem, a good outcome is more possible. Gradual sensitisation exercises often form part of the recovery; this is where intercourse is removed for a while as the body is re-trained to relax and allow all the senses to activate, without demand or fear. Couples often report there is a lot of fun and pleasure to be had from these exercises and for older couples it can bring back great memories of ‘heavy petting’ from pre-contraception days.

For most women, pain is a desire-killer and anticipating pain can further exacerbate the tension that is at the root of vaginismus. In much the same way that a traumatised animal needs to re-learn to trust that it won’t be damaged, your body needs to coaxed into trusting that there is pleasure and not pain in sexual encounters.

Consent, trust and optimism in your relationships will all assist in tackling this issue and together with professional support you should be on the road to recovery.