Sara* was a beaming, exuberant bride.

After all those hopeless Shidduch dates, meeting Dovid* was the answer to her fervent prayers and she was overwhelmed with gratitude at how much they connected. He was truly worth the wait.

The wedding was everything she dreamed of, plus more. But as Sara and Dovid joyfully left the hall to go to a nearby hotel, fears started creeping up. Though Kallah classes had been inspiring and her Kallah teacher was open and understanding, Sara had typical wedding night jitters when she thought about developing a sexual relationship. However, she found comfort in knowing that Dovid had a very gentle personality and always had her feelings in mind.

Moreover, many of her married friends said they had had similar jitters about the wedding night, and since many of them became pregnant not long after their weddings Sara presumed that their experiences with the infamous ‘first time’  would be a gateway to something better.

Only their ‘first time’ experiences didn’t match up with what her friends had talked about nor what she had learned in Kallah class. After Sheva Brachos Dovid called his Rav and explained that they had been unable to consummate the marriage due, Dovid explained, to the  feeling that his penis was hitting a wall. After an extensive conversation, his Rav surmised that Sara’s vaginal muscles were too tight. He recommended that she take baths, practice relaxation exercises, and drink a glass of wine before intercourse.

Sara’s ‘first time’ became the start of many attempts to have a ‘first time’, without success.

“Don’t worry”, the Rov kept reassuring Dovid, “plenty of couples have this issue and with time it will correct itself”. But the weeks turned into months, then years, and Sara and Dovid felt like their entire relationship was stunted from reaching its full potential.

Dovid was loving and kind, but Sara felt alone and broken. She didn’t feel comfortable confiding in her mother about her sexual challenges and  was too embarrassed to call her Kallah teacher. She had been taught that initially intercourse can be painful but with time it would evolve into an enjoyable, spiritual part of her marriage. When that didn’t happen, she began to feel like something was very wrong with her, her feelings of being ‘defective’ it only got worse when she would attend Simchas and l as she would sense curious eyes scanning her stomach.

If only she could get over this hurdle, she prayed, she could feel like a normal person.

*Names and small details have been changed to maintain anonymity

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Meet vaginismus, a type of female sexual dysfunction that contrary to popular belief, is not ‘all in your head’. Vaginismus is a condition in which the vaginal muscles involuntarily contract, making penetration painful and sometimes impossible. It can range from a mild form, where penetration is tolerable for very short periods, to so severe,  that the suffer can’t have a gynecological exam, and can’t insert a tampon, and can’t even touch herself near her vagina because the pain and the fear of the pain.  

There are two types of vaginismus; primary and secondary. In cases of primary vaginismus, a woman has never been able to have penetrative sex or experience vaginal penetration without pain. Secondary vaginismus occurs when a woman who has previously been able to achieve penetration develops vaginismus, and this may be due to (but not limited to) causes such as childbirth, infection, injury, medication side effects, cancer, or menopause. In both primary and secondary vaginismus, the physiological and psychological factors are both relevant and can play off each other, leading to exacerbation of symptoms. When a woman suspects that she may be suffering from vaginismus, it is essential that she have a comprehensive assessment that takes into account her emotional and physical symptomatology.

Suffering from vaginismus is painful physically, psychologically, religiously, and socially. As seen in Sara’s case, women with vaginismus often reflect on their suffering as casting a dark shadow not only on the marriage, but on their whole self-concept and identity. Feelings of inadequacy, incompetence,and isolation are commonly reported, and with time these feelings often intensify if the vaginismus is not treated.

The ripple effect of vaginismus often can exceed beyond the bedroom. For some men, the notion of inflicting pain on their wives via intercourse is so upsetting that it can affect their own confidence and sexual functioning, and distance may ensue as both spouses associate their sex life with pain and negativity. Overall physical affection may suffer; hugs, kisses and cuddling become tainted by the fear of where it may lead and the dreaded moment of “here we go again” that awaits.  Sadly, many couples adapt to untreated vaginismus by living like roommates; respectful to each other, set in a familiar routine, but significantly lacking in closeness.

Vaginismus is often a private struggle, and many women breathe a sigh of relief upon learning that they are not alone in their suffering, it’s not all in their head, and there is hope in eliminating the pain.  Treatment may vary based on the case, but it is often through some combination of dilation, topical creams, medications, pelvic floor physical therapy, as well as psychological support for both the woman and the couple.
In Sara’s case, a problem that went on for years was able to be rectified within a few months and she was able to finally enjoy the sexual connection that her marriage had longed for. After years of isolation, she felt reinvigorated in her whole outlook on life.  She felt excited about her relationship with Dovid, and she could smile as she looked ahead to their hopes and dreams for their future together.  And she could finally feel comfortable, present, and empowered in her body.