There is so much expectation around sex that it can be hard for someone to admit they don’t enjoy it.

Sadly, sex can be painful for many reasons and one such reason is vaginismus. Vaginismus is a condition that causes involuntarily spasms of the muscles surrounding the vagina, making penetration horribly painful and oftentimes impossible According to Self, the even things like inserting a tampon can be extremely painful. “It’s the sense of ‘hitting a brick wall’ when you’re trying to penetrate it,” said vaginismus specialist Ross Lynn Tabisel. “If penetration is possible, it will be associated with pain, chafing, burning, and the urgency to urinate.” Most women discover they have problems early on. “Interestingly enough, even women who never tried putting anything in their vagina may get a sense that ‘something is not right’ because of an inner sense that she is ‘locked up’ and penetration is not possible,” says Dr. Ditza Katz. Vaginismus is linked to anxiety disorders and Dr. Katz and Dr. Tabisel believe spasms are brought on by worrying. “The main causes for primary vaginismus include fear of pain, fear of the unknown (how will it feel inside my vagina?), religious inhibitions, perceiving the vagina as being too fragile and sensitive, past experiences with discomfort (e.g. infection, vaginal dryness, rough sex) misconceptions about sex and sexuality, and the inability to say no to unwanted penetration,” says Dr. Tabisel. “We do know that vaginismus is a common diagnosis among survivors of sexual abuse or trauma,” says gynecologist Abigail Cutler, M.D. “Sometimes, vaginismus occurs because pain is anticipated; in other words, the fear associated with painful sex causes voluntary and involuntary contraction of the vaginal musculature, which reinforces the vicious cycle,” she adds. The condition can develop later in life, especially after menopause, or treatment for female cancer. It’s hard to estimate the number of women suffering from vaginismus but it is thought to affect 1 to 6 percent of women.