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Dear Dr. Kate: Sex with My Girlfriend Is a Tight Squeeze

Thu, Apr 23, 2009

Advice, What's Up Doc?

alley
photo by mrslwalker

Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City and she answers your medical questions here once a week. To ask her your own question, click here.

Dr. Kate,

During intercourse with my girlfriend it feels like her vagina is very tight…too tight! It can actually be painful for me, but only in certain positions. My girlfriend does not admit to experiencing pain, but sometimes I wonder if it hurts her and she is afraid to admit it.

I did some research online and originally thought it might be vaginismus, but since we have been together for a long time and I’ve had a chance to “explore” the area in detail, I’m beginning to think that maybe her pubic bone is just getting in the way.¬† Can it be possible that her pubic bone is too low?¬† If so, is this causing her pain even though she is not admitting it?

I sometimes wonder if it has anything to do with her being very petite?¬† She is a size 00, so she is very small.¬† But since I am not an overly endowed male I wouldn’t think that would make a difference?

I’m also concerned about child birth problems if we get married.¬† I can’t imagine child birth going well if her pubic bone is partially blocking the way.¬† Will this cause complications?

Thanks for the help,
Boned

Dear Boned,

It’s true that women do have different shapes to their pelvis. The pubic bone may be higher or lower, along with different positions of the hip bones. You can’t tell the shape of your pelvis based on your hip measurements or height, though. Your girlfriend being petite doesn’t mean her pelvis is any more likely to be different from someone else’s. She can ask her gyno at her next exam to perform “pelvimetry” — describing the shape of the pelvis via a vaginal exam — to see if her pelvic shape could be contributing to the difficulty.

But I haven’t heard or read of women with a narrow pelvis having more difficulties with intercourse. If her vagina really feels “tight,” it’s likely because it is — and the most common reason for this is insufficient arousal before sex. While men can achieve arousal in the time it takes me to type this paragraph, the average woman needs 20 to 30 minutes of good foreplay to have enough vaginal engorgement and lubrication to make intercourse comfortable. (By “good foreplay” I mean whatever turns her on and gets her blood moving south.)

Vaginismus is certainly a possibility as well — women’s vaginal muscles are quite strong, and can really clamp down before or during intercourse, often unconsciously. While there is therapy available for vaginismus, I think your first move is to talk with your girlfriend about how she’s feeling during intercourse. She may be reluctant to tell you that she’s experiencing pain, too, and your being kind enough to begin the conversation may open the door for her. If she’s not feeling pain at all, you may need to try different positions to find the ones that are comfortable and pleasurable for both of you.

If she does turn out to have a narrow pelvis, I wouldn’t worry at this point about how she’ll experience labor and delivery. My patients have surprised me quite frequently in the past — women I thought would sail through labor aren’t able to fit the baby through their pelvis, and really petite women have birthed 9-pound babes without anesthesia (or pelvic damage).

Best of luck,

Dr. Kate
Gyotalk

Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City. She also lectures nationally on women’s health issues and conducts research on reproductive health. Check out more of her advice and ask her a question at Gynotalk.com.

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12 Responses to “Dear Dr. Kate: Sex with My Girlfriend Is a Tight Squeeze”

  1. Nick Says:

    If she were to perform regular kegel exercises it would give her more control over that area, and is likely to also give her more flexibility to let you in without causing discomfort

  2. Lotte Says:

    I doubt it would be vaginismus if penetration is possible and if she doesn’t express pain. I suffer from vaginismus, and it’s not a minor discomfort, penetration is agony, she’d be crying out if it was vag.

  3. Madamoiselle L Says:

    Lotte, I am sorry you have vaginismus. It is an awful situation to be in. I hope you are getting some treatment for it, because there are ways to make this problem tolerable and even remedy it. I know, however, that there are varying degrees of this disorder. (I am sure the doc knows more than this lowly nurse does ;) She gave all excellent information.) Some women can allow penetration, but my guess is it would probably be uncomfortable, but every woman is different.

    I agree strongly with the doc, that pelvis size has nothing to do with vaginal “tightness.” (this is more a fact than an opinion….) I have seen 4 ft 10 in women with completely perfectly formed gynecoid pelvi, who have no problem with childbirth at all, and women close to 6 ft, who have constricted or android pelvi, who cannot give birth vaginally at all. (And visa versa.) Neither have any impact on the “tightness” of the muscles in the vagina, however, they are just independent systems.

    There is good therapy for vaginismus. Usually a program of gradually larger “pessaries” (because some women get upset if we simply use the word “dildo” which is what these things are) and learning to “relax” (easier said than done and some women with this disorder simply have NO conscious control over the muscles no matter how “relaxed” they are) and a program of learning how to ease into sexual relations, with good lubrication, like the good doctor said.

    Oddly enough (doc correct me if I am wrong here) vaginismus seems to have little impact on childbirth, should these women actually become pregnant. At least from what I have seen in my limited experience. (I usually only subbed in L&D. I’m a post partum lady.) Although doing a pelvic exam on a woman with this is excruciating and not pleasant for the staff, either. (We have feelings, really.)

    One other problem could be a rather rare disorder called “adherent clitoris.” This is where there is scar tissue on the outside of the vagina, adhering the clitoris to the rest of the pudenda. (ouch) It can be remedied with a minor surgical procedure and often pessaries are used for a short time afterward. The hard part is getting it diagnosed, as many women are embarrassed to tell their doctors, “Sex hurts like hell.” Or worse, “He can’t get in. No matter what.”

    Oddly enough, Alfred Kinsey’s wife had this issue, (adherent clitoris) and it forced them to forgo intercourse for the first few months of their marriage, until “Prof” insisted she see a GYN for treatment.

  4. confused vagina Says:

    Hello Kate, during intercourse with my partner he stated i need to strenthin my muscles i guest my grip was week..i had 3 c- sections in the pass.. he last was in 10/10/2002…never had anyone say this to me before..always had partners who complain about my vagina walls being tight..just a little confsed..

  5. ariel Says:

    ok so for us “tight” women how do we loosen up? im a 24 year old female with a 3 year old. im 5’0 115 lbs, when my son was born he was 8 lbs 6 oz 21 in long. big baby, his shoulders got stuck. before my son i never had complaints of being too tight, but now 3 years later my boyfriend says that i tighten up during sex and it hurts him terribly, to the point that he just gives up and doesnt even want to try anymore. it makes me feel bad bc with him not getting “his” then i must not be doing it for him anymore. tho sex is very enjoyable for me, it doesnt hurt, and i have no problem producing enough lubrication.

  6. max Says:

    I broke up with my girlfriend of three years. She had vaginismus and things never got any better. I loved her but ended up getting sexually frustrated and angry. Everytime we tried she would tense up and I would lose my erection. She was not into giving oral sex, which was her personal choice and I accepted it. We got angry at each other about other things, petit things. In the end we had a huge row and broke up with us saying horrible things to each other. It was the easy way to end our relationship and move. I remember the first time we had sex and she cried, I think there were emotional reasons and i’ve heard about abuse etc. She never talked about it. I gave up and couldn’t give a shit. She was reluctant to seek help and in the end I just gave up. I realised how important sex is, how primitive, but so important. It’s a horrible condition and from my experience I hope I never meet someone with it again. I hope there are ways of treating it effectively.

  7. crigm Says:

    Hey Max

    That sounds really similar to my situation. I’ve been with my current gf for 4 years and she’s had the same problem. We’ve never achieved vaginal penetration and just like you, we used to get into rows over it and it affected the rest of the relationship.

    I agree that sex is very important, and I think that your decision sounds like the right move in your case.

    My situation was a little different in that my gf actually sought to get help (after some persuasion) and although the first counselor she saw was hopeless (in that, I was the one that discovered she had vaginismus, while the first counselor talked to my gf about her feelings for 12 months and I then had to convince her to also see a proper sex therapist), she is now getting very good help.

    The other thing that helps is that she is very liberal sexually, and somewhat counter-intuitively, enjoyed anal penetration. So now we are having anal sex, while she continues to get used to progressively larger “dilators” (or in our case dildos, as they are cheaper and exactly the same thing).

    So in an odd turn of events, we had anal sex before either of us had vaginal sex. I’m not complaining mind, I’m very thankful for the fact that the rest of our sexual lives are making up for the part that is missing, but obviously really want to have vaginal intercourse sooner than later.

  8. Maypaki Says:

    Primary Vaginismus.
    If you have it, then your body is NOT designed for sex.

    It is God’s way of telling a woman that she is DESTINED to become a nun or celibate.
    So if you have it, go on and BECOME A NUN.
    Or be CELIBATE.
    That’s because it is God’s way of controlling the global population. God created women with such sexual dysfunction to keep them away from sex and thus preventing conception. Unfortunately, most women don’t realize it and would still go through days and weeks of therapy which is just time consuming.

    Trying to remedy your condition is against God’s will.
    God does NOT want you to have sex.
    If you’re a woman, don’t get married & don’t have sex if your VAGINA wont let you.
    God had CLOSED the gates of your virginity.
    FACE IT! You have a NUN’S VAGINA.
    It is time to give up on men and become a NUN.

    VAGINISMUS may be the answer to overpopulation.
    God truly works in strange ways.

    Vaginismus may be the strongest evidence that God exist. Some higher power can manipulate a woman’s body for population control. I am now an enlightened man.

  9. Francessca Says:

    Maypaki – Your post maybe the stupidest thing I have ever read. How dare you spout such mumbo jumbo about women with a serious condition. FYI I am a woman who has vaginismus and I now have a normal sex life. I was unable to have sex for many years in my teens and early twenties but I didn’t want a boyfriend so it wasn’t an issue until my mid twenties when I decided I wanted a relationship. I went and had therapy once every two weeks for about 8 months and I have been able to have sex ever since. I still suffer from some pain when my boyfriend first enters his penis but this quickly disapears and I am able to enjoy sex and even have orgasms from vaginal penetration. Before my therapy I couldn’t even have anything inserted a few centimetres inside so of course my therapy worked and helped me come to terms with the issues that had led to this psychological condition. There is help out there for women and I would like to thank Em & Lo for highlighting this issue. So many women have no idea what is wrong with them. I didn’t until I saw a tv programme about embarassing illnesses. It’s so important to talk about this issue.

  10. YesOkCool Says:

    Really, Maypaki? I totally agree with Francessca. Your post is not only idiodic but extremely insensitive. Personally being an athiest, i take offense that you use your personal beliefs to target these poor women. You need serious help.

  11. amy Says:

    I wonder if Maypaki’s post could be removed – it is extremely offensive and INCORRECT ! I suffer with this condition and was free of it for the first 35 years of my sexual life. It is horrible. I too had some one break up with me over it even though I was actively seeking help for it and it had only been a problem for 6 months of our 3 year relationship. I gave up trying to fix it when he dumped me because I was so crushed, but now I want to try and fix it again.
    I also find Max’s comments pretty harsh. I dont hear any empathy for his ex girlfriend in his post even though I do understand that it is difficult for the man too. But can Max imagine having excruciating pain in his penis and testicles all the time and wishing he didnt and then being rejected for it? Really, have some compassion at least. Its heartbreaking and sexually frustrating for women to not be able to have sex the way they want to, also.
    I wonder, could people list what kind of therapy they have had besides the dilators, that has helped? I have tried them and it had not changed anything. Just wondering what else I need to try to go back to a healthy sex life!
    Thanks!

  12. emandlo Says:

    Hi Amy, we considered taking down Maypaki’s comment — because you’re right, it’s offensive and incorrect — but ultimately we decided it’s important to see how some people use religion to justify their sexist beliefs. (This is of course giving him the benefit of the doubt and assuming his was a sincere post.) Maypaki is not unlike Senate candidate Todd Akin, a religious man whose faith allows him to ignore science — and disrespect women in the process. The Republican Party definitely wished Akin hadn’t been caught talking about “legitimate rape” in public, but it was important the world saw that these kind of crazy, sexist, faith-based views are still held today in the 21st century. Same here. And you, along with our other wise readers, do a very good job of discrediting the fringe like Maypaki and spreading reality-based truth.


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