Ask Dr. Ruth: How Do I Overcome a Vaginismus Diagnosis?

After 30 years of working as a sex therapist, the legendary Dr. Ruth isn’t done sharing her wisdom. Here, she answers your most pressing questions on sex, relationships and life. Email your own queries to drruth@time.com, or catch up on previous installments of the Ask Dr. Ruth series.

Q: I’ve been married for eight years and have recently been diagnosed with vaginismus by my gynecologist. Our marriage isn’t perfect, but this diagnosis seems out of the blue. My doctor told me this issue is likely psychological — what could be the cause and how do I overcome it?

A: Vaginismus is an involuntary tightening of the vaginal muscles that makes intercourse either painful, or, if the muscles are very tightly clamped together, impossible. It’s a condition that’s more commonly encountered at the beginning of a sexual relationship, but can also occur at any time. It can be caused by physical issues, such as menopause or trauma, but as it’s often psychological, one source could be a problem in the overall relationship.

It’s possible that something outside of the bedroom is affecting you inside the bedroom. It could be something that seems minor, like that he doesn’t help you around the house enough, or it could be more serious. Whatever the problem is, it could be causing your subconscious to make intercourse impossible by an involuntary tightening of your vaginal muscles.

While you may have gone to a gynecologist for the diagnosis, you may also need to visit a marriage counselor to help you find a cure. Once you check in on your relationship, you’ll be able to tackle the vaginismus — whether that be with couple’s therapy or a medical doctor.

Email questions to drruth@time.com.