The Vaginismus Treatment Formula
Sarrel, P. and Sarrel, L. (1989). Dyspareunia and vaginismus. In Treatment of psychiatric disorders, Vol. 3 (ed. American Psychiatric Association Task Force on Treatments of Psychiatric Disorders), pp. 2291-8. American Psychiatric Press, Washington, DC. 82. Leiblum, S., Pervin, L., and Campell, E. (1989). The treatment of vaginismus success and failure. In Principles and practice of sex therapy update for the 1990s (ed. S. Leiblum and R. Rosen), pp. 113-40. Guilford Press, New York. 84. Drenth, J. (1988). Vaginismus and the desire for a child. Journal of Psychosomatic Obstetrics and Gynecology, 9, 125-38. 86. Fordney, D. (1978). Dyspareunia and vaginismus. Clinics in Obstetrics and Gynecology, 21, 205-21. 88. Scholl, G. (1988). Prognostic variables in treating vaginismus. Obstetrics and Gynecology, 72, 231-5.
Sexual pain disorders are divided into two dysfunctions non-organic dyspareunia and vaginismus. Dyspareunia, genital pain in either a male or female, is characterized by recurrent and persistent genital pain before, during, and after sexual activity. Exclusively a female dysfunction, vaginismus is an involuntary spasm of the musculature of the outer third of the vagina which makes penetration difficult or impossible. Non-organic dyspareunia and vaginismus may only be diagnosed in the absence of detectable physical pathology. However, when the aetiology is entirely physical there is likely to be a conditioned psychological response that may require subsequent psychological intervention after medical treatment. (79 Tabje.8 and Iable.9 list the DSM-IV and ICD-10 diagnostic criteria for sexual pain disorders. Vaginismus is not necessarily limited to sexual situations. Typically, women with this disorder have been unable to insert tampons or permit insertion of a speculum during...
Sexual pain disorder is the persistence or recurrence of genital pain associated with sexual stimulation and intercourse, which causes personal stress. Dyspareunia, pain upon intromission, and vaginismus, or the reflexive closing of the vaginal introitus, are types of sexual pain disorders. Pelvic trauma, such as seen with childbirth injuries and CRS, as well as psychological trauma, may be associated with this disorder.
Vaginismus is most likely multicausal and overdetermined in aetiology.(82) The precipitating events range from specific childhood or adult trauma to unconscious conflict, although attempts to link vaginismus to childhood or adult sexual abuse have not been empirically validated. Analytically oriented therapists have speculated that vaginismus reflects the woman's rejection of the female role, as a resistance against a male sexual prerogative, a defence against her father's real or fantasized incestual threat, and attempts to ward off her own castration images. (84 Spence(26 suggests that fears of pregnancy, strict religious adherence, disgust regarding genitalia, partner dissatisfaction, and irrational beliefs about anatomy underlie the development of vaginismus. Finally, learning theorists understand the dysfunction as a conditioned fear reaction reinforced by the belief that penetration can only be accomplished with great difficulty and will result in pain and discomfort.