Vaginismus - Treatment

Treatment

There are a variety of factors that can contribute to vaginismus. These may be physical or physiological, and the treatment required can depend on the reason that the woman has developed the condition. As each case is different, an individualized approach to treatment is useful. The condition will not necessarily become more severe if left untreated, unless the woman is continuing to attempt penetration, despite feeling pain. Some women may choose to refrain from seeking treatment for their condition, or be unaware that treatment might be available or even that their difficulties constitute a medical condition.

According to the Cochrane Collaboration review of the scientific literature, "In spite of encouraging results reported from uncontrolled case series there is very limited evidence from controlled trials concerning the effectiveness of treatments for vaginismus. Further trials are needed to compare therapies with waiting list control and with other therapies." Although few controlled trials have been carried out, many serious scientific studies have tested and supported the efficacy of the treatment of vaginismus. In all cases where the systematic desensitization method was used, success rates were approximately 90% or better. For an example of one of these studies, see Nasab, M., & Farnoosh, Z.; or for a basic review, see Reissing's literature review (links below). A Dutch study showed that many women were subsequently able to be penetrated, but far fewer women actually enjoyed being penetrated.

One treatment that is employed is the use of vaginal probes. Vaginal probes are graduated or tapered blunt-ended probes. They come in different sizes, usually no larger than the size in length and diameter of a tampon. Here, the woman can work with a trusted nurse practitioner, doctor, specialized physical therapist, or other person trained in sexual dysfunction and disorder, to help her organize a therapeutic program to (slowly and gradually) assist her in overcoming her fear of penetration. Vaginal probes are introduced into the woman's vagina, usually with her own hand so that she can maintain control both physically and psychologically over the rate of insertion. This procedure requires a great amount of trust and compassion to take place between the patient and the practitioner for the outcome to be successful.

When used properly, vaginal dilators are effective tools to further help eliminate pelvic tightness due to vaginismus. Dilators provide a substitute means to trigger pelvic muscle reactions. Effective dilator exercises teach women how to override involuntary contractions, relaxing the pelvic floor so it responds correctly to sexual penetration. Graduated vaginal insertion exercises allow women to comfortably transition to the stage where they are ready for intercourse without pain or discomfort.