Monique Pittman didn’t know the first time she had sex, she would wind up screaming in pain. Pittman, a freelance photographer and photographer’s assistant in Chicago, IL, had waited until her wedding night to have sex for the first time — an experience that should have been about growing intimacy between newlyweds. Instead, Pittman was blindsided by a tearing, stabbing, burning pain in her vagina, the result of a condition called vaginismus.
Vaginismus occurs when muscles in the pelvic floor (which supports the bladder, uterus, and anus) contract during penetration. These spasms can be painful enough that any kind of penetration, even with a tampon, is impossible. Pre-existing physical, psychological or emotional anxieties may trigger or compound that pain, and the stress from painful penetration can also cause anxiety, sometimes resulting in a vicious cycle that’s difficult to break.
The road to recovery is complex, because the causes are complex: trauma can cause pain, which makes experiences traumatic, which causes more pain. Women with vaginismus are encouraged to seek a multi-part treatment, balancing gynecological appointments, therapy or sex counseling, and pelvic floor physical therapy. But there’s no set path to recovery that will work for all women. “It takes a different amount of time to get over something like this” for each individual, said Liz Miracle, a pelvic physical therapist in San Francisco.
At the time of her marriage, Pittman says she’d never inserted anything into her vagina; penetration was “foreign.” Raised by her mother and her grandmother in a Roman Catholic household, Pittman witnessed her grandmother “talk so much trash” about sex as a reaction to her mother’s promiscuity. “[My mother] always had a different guy that she was sleeping with,” she said, “and my grandma really frowned upon that.”
With her family’s influence, Pittman decided she didn’t want to have sex before marriage. Years later, after she first stopped believing in God and then became a born-again Christian, she was glad she’d waited; having sex after marriage, Pittman said, allowed her to understand the value of intimacy.