Sex & Relationships
expert advice on painful sex in women
When Sex Seems Impossible
How is it possible that it can be impossible to have sex? Ask the thousands of women around the world who suffer from vaginismus. They are normal women like you and me who love their partners and who would love to have sex with them but are living in unconsummated relationships due to vaginismus.
People who suffer from vaginismus have a few things in common:
Involuntary Pelvic Floor Muscle Contraction
This is often described as 'hitting a wall'. Depending in the degree of the contraction, the women often have an inability to do the following:
• Insert a tampon
• Undergo a gynecological examination
• Have penetrative sex
Intense Fear Of Penetration
In some cases it can be so severe that the woman gets a panic attack when an examination is attempted or if her partner goes anywhere near her genitals. The reason for this fear differs from patient to patient, but some patterns that we do see are:
• Ladies who had very strict religious upbringing with misconceptions about sex
• Ladies who have experienced childhood sexual abuse
• Ladies with general anxiety disorders
In many cases, no specific cause for this fear can be established.
Pain Associated With Penetration
Because of the severe muscle spasm penetration is painful, which reinforces the fear and sets of the vicious cycle over and over again.
What is the good the news? There is treatment for vaginismus!
During the treatment we brake the vicious cycle by teaching the ladies to relax and control their pelvic floor muscles through physiotherapy and biofeedback. This makes penetration possible and not painful. In this process, we also help them to deal with the fear through cognitive behavioral therapy and sex therapy. In some severe cases, botox is used to relax the pelvic floor muscles.
When Sex Seems Impossible is a new book by Dr Peter T Pacik (Odyne Publishing) telling the stories of the many women he has seen with vaginismus – a very interesting read.
About this blog

Dr Elna Rudolph is the clinical head of the Intercare Centre for Sexual Health and is one of only two doctors in South Africa with a masters degree in sexual health. Her work includes sexual health check-ups, contraceptive management, the treatments of STIs as well helping patients with sexual health issues such as low libido and those who experience painful sex. She also provides medical services for the LGBT (lesbian gay bisexual and transgender) community.










Another reason why intercourse may not be possible is due to vulvodynia. I've been sufferring from this condition for more than 13 years. Are there any new developments in the treatment and cure of this condition?
I have had wonderful success with treating women with vulvodynia according to the latest research. The treatment approach is based on the most likely cause for your vulvodynia. If I take a full history and do a detailed clinical examination I am confident that I will know what the cause is and treat you for it - give it a shot - vulvodynia is a terrible condition to be living with for 13 years! I dont know if you are close to Pretoria, but my office number is 012 809 6000. E
I'm 25 and suffer from this condition and I've been looking for clinics in RSA offering treatment for this condition with no success can I please have Dr Rudolph's contact details
im 25 and every time I have sex its painful. i know that one is supose to relax, however that realy doesnt help. what else can one do do enjoy a sex with your patner?? can i have doctor rudolpg's contact details as well. thank you
My office number is 012 809 6000 - please make an appointment. I have helped many girls with the same problem and they are having pain-free sex today.
I have been experiencing pain during and after sex for a the past three to four years. I get well lubricated before sex and my husband is gentle when we make love. I get swollen after the sexual encounter. My husband is highly sexually charged and we normally have sex once a week but because of the pain the experience is becoming unbearable and it is now affecting my marriage. I have called the 012 809 6000 number to make an appointment on a numberous occassions but the receptionist always cuts me off ( it is quite unprofessional and irritating to say the least
Hi Pat
I am extremely sorry to hear about your frustrating experience with my reception staff!!!
Will you kindly email me directly and provide me with your contact details and I will get Sr Laurenza to contact you to arrange an appointment.
elna.rudolph@intercare.co.za
Kind regards
Dr Elna Rudolph
Hi Pat
I am extremely sorry to hear about your frustrating experience with my reception staff!!!
Will you kindly email me directly and provide me with your contact details and I will get Sr Laurenza to contact you to arrange an appointment.
elna.rudolph@intercare.co.za
Kind regards
Dr Elna Rudolph
Hi Pat
I am extremely sorry to hear about your frustrating experience with my reception staff!!!
Will you kindly email me directly and provide me with your contact details and I will get Sr Laurenza to contact you to arrange an appointment.
elna.rudolph@intercare.co.za
Kind regards
Dr Elna Rudolph
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