For many women, attempting to have intercourse causes intense pain or fear of pain. It can seem as if there is "no way in", almost as if there is a brick wall blocking the entrance. Sometimes it is not as extreme as that, but still very difficult. In severe cases, when the muscles at the opening of the vagina go into spasm, it is called vaginismus. Other muscles in the body may tense up if penetration is attempted, with the knees clamping together and the shoulders and chest curling in as if to protect the body from some threat.

In the vast majority of women with vaginismus, there is nothing physically wrong with the vagina, it is just tense. Intense fear makes the body and the vagina tighten up so that it is almost closed and nothing can get in. This problem is almost always curable, although if you are suffering from it, that may seem hard to believe.

Physical examinataion can be difficult because of all the muscles tensing up, but it is important to try to make sure there really is nothing physically wrong before starting treatment. Very occasionally there may be a bit of hymen which can cause pain, or a birth defect. A Family Planning Clinic or Well Woman Clinic could check this for you.

Margaret Ramage is the Partner Therapy Group's expert on vaginismus.