If sex feels like pushing a steamboat into a car tunnel, you might be experiencing some of the following vaginal issues.
Vaginismus
This sudden, involuntary tightening of the vaginal muscles upon penetration can result in extreme discomfort and pain during sexual intercourse. It generally occurs during a woman’s first sexual experience, but can also affect her after this point, particularly if she attempts intercourse when emotionally distressed.
Treatment
Upon professional or self-diagnosis, this problem can be resolved with the gradual insertion of increasingly larger objects. At first, women are often instructed to touch an area as close to the vaginal opening as possible without any pain until they can insert a finger.
After this point, they might be offered cone-shaped inserts, which they will practice inserting for increasingly longer times. Eventually, they should be able to work their way up to painless intercourse.
Menopause
Menopause induces dryness and thinning of the vaginal tissues as a result of a decrease in bodily estrogen levels, which can often lead to a sensation of “tightness” during sex.
Treatment
Topical estrogen is often prescribed to assuage inadequate lubrication. Another drug, called ospemifene, behaves the way bodily estrogen does on the vaginal lining, but not on the breasts.
Therapies that don’t use medication include desensitization therapy, during which you learn how to relax your vaginal muscles to decrease pain, and cognitive behavioral therapy, which can also help amend thought patterns that exacerbate the feeling of tightness.
Endometriosis
This is a condition in which tissue that resembles uterine lining grows on other organs such as the ovaries, fallopian tubes, or bowel. These abnormal growths can often cause a feeling of tightness or discomfort during sex.
Treatment
Often, experimenting with different positions that put less pressure on problematic areas of the pelvis can assuage this symptom. Other actions your doctor might recommend you take include having a warm bath before sex, using lubrication, and extending foreplay.
Pelvic inflammatory disease
Pelvic inflammatory disease (PID) is an infection of the female reproductive organs that usually occur when bacteria that you are exposed to during sex spread from the vagina to the uterus, fallopian tubes, and ovaries. This condition can cause pain or bleeding during intercourse.
Treatment
Your doctor will likely prescribe antibiotics that you must finish, even if you start to feel better before the course is up. After you are treated, make sure to use condoms during intercourse as this will decrease your risk of exposure to PID-causing bacteria in the future.
Psychogenic pain
This disorder causes people to perceive pain without an identifiable stimulus. Although this condition is rare, it can be the trigger for feelings of tightness and pain during intercourse.
Treatment
Psychogenic pain is often more difficult to treat than traditional, nociceptive pain. Usually, patients with this condition are prescribed antidepressants or non-narcotic painkillers (such as ibuprofen or acetaminophen), or are advised to seek psychotherapy.
Sources:
https://www.nhs.uk/conditions/vaginismus/
https://www.issm.info/sexual-health-qa/can-the-vagina-tighten-over-time/
https://www.psychologytoday.com/us/blog/all-about-sex/201109/the-rare-truth-about-tight-and-loose-women
https://www.merckmanuals.com/home/women-s-health-issues/sexual-dysfunction-in-women/vaginismus
https://www.menopause.org/for-women/sexual-health-menopause-online/sexual-problems-at-midlife/pain-with-penetration
https://www.medicalnewstoday.com/articles/321417.php
https://www.healthline.com/health/pelvic-inflammatory-disease-pid#treatment
https://www.webmd.com/pain-management/guide/pain-management-psychogenic-pain
