Summarize the following:
A therapist can be helpful whether or not your vaginismus is caused by emotional or psychological issues. This is because awareness of the condition itself often produces fear and anxiety before intercourse, starting a vicious cycle that exacerbates symptoms. Feelings of depression, isolation, and lower self-esteem are also common effects of the stigma of sexual dysfunction. Treatment outcomes are much more positive when the woman and her sexual partner are motivated, cooperative, and resolve to lessen relationship conflicts. So, a couple's psychological evaluation is a great beginning to treatment. If your vaginismus is connected to anxiety issues or past sexual trauma, a therapist can help you deal with these issues so you can start to move forward. One particular type of therapy, cognitive behavioral therapy (CBT), can be especially helpful to some women. CBT focuses on the relationship between thoughts and behaviors, and a cognitive behavioral therapist can help you change your thoughts and behaviors regarding avoidance of sexual intercourse. One treatment for vaginismus is called exposure therapy, or flooding, and it involves gradual desensitization to penetration. Therapist-aided exposure to penetration is an effective treatment, even for women with lifelong vaginismus. The techniques for exposure usually involve vaginal penetration exercises using dilators. This is the same method used for self-treatment, with the addition of a guide who can help you continue on your own with confidence and success. Ask your doctor to refer you to a physical therapist who has experience dealing with vaginismus and other forms of female sexual dysfunction. Because the muscles of the pelvic floor play such a major role in vaginismus, physical therapy is one of the best treatment options. Your physical therapist might: teach you breathing and relaxation techniques help you learn pelvic floor muscle contraction to control your pelvic floor muscles Kegel exercises are designed to help you control the muscles of your pelvic floor. To do a Kegel exercise, you simply contract the muscles you would use to stop the flow of urine, hold for a few seconds, then relax. Aim to do about 20 contractions at a time, as many times a day as you can. Some doctors recommend doing Kegel exercises with a finger inserted into your vagina (you can work up to three fingers). Using your finger allows you to feel the muscle contracting in order to better control its movements. Your doctor may recommend vaginal dilators to use at home. These are cone-shaped instruments that are placed in the vagina. They get progressively larger, enabling the muscles of your vagina to stretch and become accustomed to penetration. To begin, bear down as you would when having a bowel movement. This helps enlarge the vaginal opening. Then, insert fingers (not the dilators yet) into your vagina, continuing to push or bear down. When you begin using the dilators, leave them in for 10 to 15 minutes. The vaginal muscles will become used to the pressure. If you have a spouse or partner, you may want to ask this person to help you insert the dilators. Women with vaginismus need to be patient and try treatment options before jumping into sexual intercourse. If you try to become sexually active right away, you may experience pain or discomfort, and this sets you up for a cycle of pain and anxiety that worsens vaginismus. It is vital that you have a patient, supportive partner. When you do try to have sex, go very slowly, use plenty of lubricant, and experiment to find the most comfortable positions. Doctors typically suggest that women hold the penetrative object and place it partially or completely in their vagina as they have done with vaginal dilators. This applies equally to penises, dildos, and vibrators.
Try counseling. Ask about exposure therapy. Find a physical therapist. Do Kegel exercises. Consider at-home vaginal dilators. Take sexual activity very slowly.