When the Body Says No: How Sexology Helps Women with Vaginal Pain Reconnect with Themselves

Vaginal pain—whether dyspareunia (pain during intercourse) or vaginismus (involuntary contraction of pelvic floor muscles)—is far more than a medical issue. It is often the silent reflection of internal conflicts, complex personal histories, and deeply rooted personality traits. In sexological support, it’s not enough to address the physical symptoms; we must also meet the woman behind the pain.

The Role of the Sexologist: Beyond Muscles and Mucous Membranes

A sexologist works with the person as a whole. When a woman seeks help for sexual pain, part of the work involves exploring not only biological aspects, but also beliefs, emotions, relationships, and… personality. Because often, it’s not just “it hurts,” but rather “I feel bad.”

Common Personality Traits

Certain personality tendencies are frequently seen in women who suffer from chronic vaginal pain. These traits are not direct causes but are vulnerability factors that influence how the pain is experienced, interpreted, and maintained over time.

Perfectionism

These women often have a strong need for performance, control, and conformity. Their body becomes yet another area where they feel they must “get it right,” even when it hurts. They have little tolerance for imperfection, which makes it hard to accept their difficulties. They also tend to isolate themselves with the problem and feel broken or abnormal. However, this issue is actually very common among women.

Hyper-responsibility and the Need to Please

Many were raised with the implicit message that they must care for others before themselves. They strive to be “good partners,” to not disappoint, to not cause waves. This drives them to maintain painful sexual activity at the expense of their own well-being. Over time, the pain worsens and sexuality becomes associated with an unpleasant task.

Difficulty Expressing Needs

Many women struggle to say no, to set boundaries, to assert their desires. Their body then becomes the messenger: it says no for them. Setting boundaries also comes with fears about how their partner might react. They have low tolerance for conflict and tend to avoid it.

Anxiety and Negative Anticipation

Anticipating pain leads to both physical and psychological tension. The vagina becomes a site of alertness and vigilance. The more one anticipates pain, the more deeply it becomes ingrained. General anxiety is also often seen in the daily lives of these women. This constant hypervigilance makes it difficult to relax during sexual activity. Emotional regulation must therefore be addressed both broadly and specifically in relation to sexuality.

Shame or Sexual Taboos

A background marked by silence, modesty, or guilt around sexuality often leads to a dissociated relationship with the body, where pleasure is suspicious and pain is normalized.

A Fragile Feminine Identity

Many women with this difficulty perceive their femininity as flawed. Either the issue creates this perception, or it may stem from it. Without a solid relationship with their feminine identity, sexuality often suffers. This may manifest as a lack of confidence, a shaky body image, or negative views of female sexuality (e.g., internalized slut-shaming).

The Impact on Sexuality

These personality traits interact with pain in complex ways:

• Desire fades, not because it no longer exists, but because it becomes tied to suffering, impossible performance, or obligation.

• Pleasure becomes inaccessible, as the body shifts into defense mode instead of openness.

• The relationship with the partner is affected, often colored by guilt, shame, or unspoken conflict.

• Intimacy becomes threatening, which increases isolation and fuels a vicious cycle.

Sexological Support: An Identity-Based Approach

Helping these women means offering a safe space to reconnect with their body, redefine their permissions, deconstruct limiting beliefs, and develop deeper self-knowledge. This journey may include:

• Psychoeducation about sexuality and pain.

• Learning intimate communication, to set boundaries without guilt.

• Exploring emotions, to restore space for pleasure and desire.

• Bodywork with a pelvic floor physiotherapist, to soothe the body’s defensive response.

• And most importantly, an identity journey, to shift from “I have to do” to “I choose to be.”

In Conclusion

Vaginal pain is not just a mechanical problem—it is often the language of a body that has much to say. Sexological work helps women give meaning to what their body is expressing, reconcile their head and their sexuality, and reclaim a chosen, vibrant, and finally pain-free sexual life. The goal is also to bring pleasure back into sexuality, which is the cornerstone of fulfilling sexual experiences.

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