After a Three-Year Hiatus, Sex Has Become Painful 

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Dear Reverend, 

I've recently begun to have sex again after a three-year hiatus. I am not able to have penetrable sex, though, because it's too painful. My legs close shut right at the slightest insertion. It's even difficult to insert a finger! Why?

No-Go Nanette (female, 33)

Dear No-Go Nanette, 

The old saying "If you don't use it, you lose it" doesn't really apply to the trusty ol' vagina. After a long dry spell, you may be a little rusty, but if you're premenopausal, you should be able to get back to business without too much trouble.

A major cause of painful vaginal intercourse is lack of lubrication. Having sex after a long time can create some anxiety, which can result in decreased arousal. Having painful intercourse once can lead to the fear of it happening again, which can further mess with your level of arousal. Make sure you're relaxed, and spend plenty of time in the foreplay zone to get the wheels greased and ready to roll.

If arousal isn't the issue, you may have vaginismus. It's a condition in which there is an involuntary tightening of the vaginal muscles, which can make penetration painful or impossible. This can occur after physical or psychological trauma, but it can also happen seemingly out of the blue. Luckily, it's highly treatable with physical therapy and relaxation techniques.

Sex shouldn't hurt — unless you it want to — so I recommend that you consult your primary care physician or gynecologist ASAP to get to the bottom of the problem.

Good luck and God bless,

The Reverend