When sex is painful: Why you should get a sexual health check-up before trying for a Dragon baby

Ms Nisa Maideen and Mr Mohamed Razeen say their journey to overcome painful sex has brought them closer. ST PHOTO: NG SOR LUAN

SINGAPORE – When Ms Nisa Maideen married Mr Mohamed Razeen in late 2020, the couple decided to spend six months settling into married life before starting a family.

Once they started trying for a baby, though, she realised it was not the “straightforward process” she had expected.

To begin with, sex was very painful.

“Culturally, we didn’t grow up talking about this, so intimacy was not the easiest for me, even though I was very comfortable with my husband,” says Ms Nisa, 34, who works in human resources.

Meanwhile, Mr Razeen, 35, a transformation manager, could not bear to see his new wife suffer even though he knew how much she wanted to have a baby as soon as possible.

“From my perspective, it was, like, why am I putting her through such pain?” he says.

In mid-2021, they visited a private obstetrician and gynaecologist who told Ms Nisa there was nothing physically wrong with her and sent her home with a set of dilators. These are devices that help stretch vaginal tissues for those who experience pain during sex, but she found using them “traumatising”.

Ms Nisa suffered in silence until some time in 2022, when she confided in her family doctor, who referred her to Dr Jean-Jasmin Lee, a consultant with the Family Medicine Service at KK Women’s and Children’s Hospital (KKH).

There, Ms Nisa discovered she had vaginismus, a condition where the muscles in the vagina tighten involuntarily, making intercourse difficult for both partners. It can even hinder vaginal medical examinations in some women.

Vaginismus is one of the most common female sexual dysfunction (FSD) conditions here, Dr Lee notes. FSD refers to persistent and recurrent problems with sexual responses, which 30 to 50 per cent of all women suffer from.

The hospital has seen a threefold increase in the number of patients with vaginismus from 2017 to 2023, which she attributes to greater awareness among the public and healthcare providers.

Today, nine in 10 patients at the sexual health clinic under the KK Women’s Health and Wellness Centre have this condition. Most of the women it sees are between 30 and 39 years old.

The clinic also sees the male partners of women with FSD. Their top three issues are psychogenic erectile dysfunction, where the man has difficulty having or sustaining an erection as he does not want to cause his partner pain; loss of libido, which may be due to myriad reasons; and relationship issues.

These three conditions for men have also been on the rise over the last few years, Dr Lee notes. She is one of the speakers at KKH’s Women’s Health and Wellness Public Forum on April 13 (for.sg/womenhealthpf).

The National University Hospital (NUH) has also seen a rise in vaginismus, also known as genito-pelvic pain or penetration disorder, according to Dr Judith Ong, an associate consultant at the hospital’s Division of Reproductive Endocrinology and Infertility, which sits within its Department of Obstetrics and Gynaecology.

She did not specify the exact increase, but NUH offers a relationship counselling clinic with professionals in psychosexual therapy to help such couples.

Dr Ong says while vaginismus is mainly a psychological issue, physical and non-physical factors, such as childhood experiences and relationship factors, also play a role in triggering it.

With some couples eager to conceive Dragon Year babies in 2024, experts say the stress of trying can backfire and affect their chances of conception, especially when they have not taken care of their sexual health.

While KKH does not track such numbers, the sexual health clinic team has seen “a few couples” who have had sexual health issues for years but came forward only recently because they wanted a Dragon Year birth.

As Chinese New Year in 2025 falls on Jan 29, couples have to conceive by late April 2024.

Mount Elizabeth Fertility Centre says it has noticed a 5 to 10 per cent increase in couples seeking help since July 2023. NUH has not seen an increase in couples seeking Dragon Year babies, Dr Ong says.

KKH’s Dr Lee says: “Most couples know they need to optimise their health, which includes having healthy eating habits, avoiding high-risk activities, and maintaining a healthy weight and regular exercise. However, not all are aware that optimising health involves optimising and prioritising sexual health as well.”

Left unresolved, such female sexual dysfunction issues “may affect the mental and physical health, relationship and quality of life of both the woman and her partner”, she warns.

It is also a key barrier to conception and procreation, Dr Lee adds. “Worldwide studies show that once a couple show symptoms, they should seek help within two years for the best treatment outcomes.”

Besides a doctor, patients at KKH’s sexual health clinic may also have to see a psychologist and physiotherapist. It is the only multidisciplinary clinic in Singapore where all team members are certified in the management of sexual health issues, Dr Lee says.

Ms Nisa also saw a physiotherapist who taught her breathing and stretching exercises, and how to familiarise herself with her reproductive parts. She learnt how food intake affects sexual health and avoided fast food to maintain the pH balance in her reproductive organs.

Her husband, who attended the sessions with her, helped her with some of the exercises and offered emotional support.

She says she appreciated that Dr Lee checked in on her husband because, “as much as it is difficult for me, he is also involved in the process”. It was a far cry from her first private consultation, where Mr Razeen remained in the waiting room when she saw the doctor.

Dr Lee says: “Partners play a very important role in successful conception, especially for couples with sexual health issues. In our experience, success factors that influence progress include commitment and motivation levels, as well as the amount of spousal support and involvement.”

Couples need to communicate openly and be willing to seek professional help together, Dr Ong says. “FSD is treatable and the first step is being willing to talk about these issues.”

After about four months of visits, Ms Nisa and Mr Razeen tried for a baby on their own, but her eagerness to get pregnant saw her shedding tears every time her period came.

“We were close to zero before, and for us to have painless intercourse, it was a big deal,” Mr Razeen says. “So, I had to keep reminding her about the progress she has made and to keep the faith.”

In September 2022, she felt lower back pains but tempered her expectations. The moment the early riser woke up at 4am, she reached for a pregnancy test kit. Her hands trembled as the test turned positive.

Today, the couple are proud parents to a baby boy named Zayn, who will celebrate his first birthday soon. Their journey to parenthood has brought them closer.

“I really couldn’t have done much without Razeen’s support,” Ms Nisa says. “He was a very strong support and kept me going. I’m sure it wasn’t easy for him either.”

She says they decided to share their journey on this often-taboo topic as a way to pay it forward.

“This is really out of the comfort zone for someone like myself who is embarrassed about sharing this, but if we are able to help even one couple out there, it’s in some way like giving back to the clinic.”