Vaginismus is seen as woman’s inability to have intercourse due the vagina tightening. The vagina will clamp itself together making sexual intercourse basically impossible. It is based on a number of factors: biological, physiological, psychological, and cultural.

Women who experience Vaginismus are usually sexually responsive and enjoy clitoral stimulation, sexual contact, and sex play, as long as it does not lead to intercourse. Since there is a physical condition obstructing the vagina’s hole, it must be diagnosed by through a pelvic examination.

Often many people will attempt intercourse making it frustrating, painful, but ultimately unattainable. The process of penetration is usually painful for both, and can be humiliating, frustrating, and confusing for both people. Since sexual intercourse is impossible, it can be extremely psychologically damaging to both the woman and her partner.

This condition causes many women to avoid all sexual contact to intercourse creating a phobic response to sex. Many men partners do not know how to react and can feel a sense of rejection, leading to his own secondary impotence.

Many times, painful intercourse, or Dyspareunia, causes Vaginismus. As long as intercourse is painful, the vaginismic reflex will continue. There are medical procedures, to enlarge the introitus surgically, which may not treat the problem. The procedure may work, it may permit penetration, but it may also prevent orgasm and lack of interest in sexual activity.

The normal sexual aroused state requires a relaxed mindset. This visceral response is regulated by the autonomic nervous system. If the autonomic nervous system is upset, it can cause negative emotions, reshifting of the blood flow (away from the abdomen and genitals), as well as spastic muscles. A number of these issues can affect the excitement and plateau stages of female sexual response. Thus, making it difficult, if not impossible, to respond sexually.

The psychological aspect of Vaginismus is also important. The perspectives a person has regarding sex will impact their sexual response and satisfaction. Sexual response is a biological function, but it is also dependant on psychological factors. If most women who have this dysfunction are unresponsive to sexual contact, the thought of such contact is stressful. Past sexual experiences or if sex is painful, then they will continue to have anxiety and an attitude enabling the non-responsive behavior. Fearing of pain, judgment of a partner, or reluctance to communicate needs can all create emotional reactions that impair sexual response.

Treating All Sexual Dysfunctions

It is important to go and see a physician and psychologist/clinician to help determine if a woman has a sexual dysfunction. A physician would help to determine that the female sexual response cycle is not inhibited by any physical factors. Sometime hormone replacement therapy may be necessary if her hormone levels are less than normal. If there is a blood flow problem, then some vascular treatments may be done. Creams to handheld devices may be used to increase blood flow. Also, nerve-related loss in the genitals may be present and addressed.

A sexologist, sex therapist, or psychologist would help determine the psychological factors that may be aiding in the sexual dysfunction. The evaluation would include looking at your past and current sexual practices, as well as providing educational tasks to assist in treating the dysfunction. All female sexual dysfunctions benefit from a clinicians education of female sexual response cycle, environmental stimulation, as well as promoting self-knowledge regarding sexual practices.

Psychologically Treating - Vaginismus

Often the vagina will have to go through a deconditioning process which will start a gradual desensitizing of the spastic and tight vagina. It consists of a general insertion of a small catheter, which over time increases to the average penis size to help facilitate a deconditioning process.

Usually there a range of phobic elements creating the Vaginismus. Many of the issues may stem from past sexual experiences, including abuse. It can also stem from a lack of communication and sexual comfort between the partners. It is important to examine these issue to help relax and decrease anxiety, and treat the Vaginismus.

There are surgical methods to help enlarge the introitus, but it is best to try a therapeutic approach prior to surgical methods.

Psychologically Treating – Dyspareunia

There are a number of physical reasons that dysparenia, or pain during intercourse, exists. It is important to get a physical exam to find out if there are any physical factors are causing the dysfunction. 

Like most female sexual dysfunctions, it is important to help the woman change her sexual environment.

The need for a relaxing, non-demanding, sensual environment is necessary for the natural progression of sexual response. The obstacles that prevent relaxation and sexual response need to be determined and removed to help foster sexual desire, response, and pleasure.

Often steps are taken in therapy to work towards sexual response. It may start out with sensate focused experiments, or general body massage. This is a good way to help associate touch to a positive experience. 

The exercises will generally progress to genital stimulation. Then to non-demanding (or no expectation of orgasm) sex are used as tools to help women. All of the practice will be done privately at-home, but the discussion in therapy and often slow progression of exercises will help treat dysfunctions.