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Treating Vaginismus with Therapy

Heidi A Sauder, PHD
Mar 6, 20242 min read

Vaginismus is when vaginal muscles involuntarily spasm or contract during an attempted penetrative event. This can result in pain, anxiety, and distress. Vaginal pain and pelvic pain are complex and have many factors. Many people bear the pain of vaginismus but treatment is available with sex therapy. If vaginismus is getting in the way of a fulfilling sex-life, a healthy relationship with your body, or causing distress in your life in any way, consider sex therapy. Here is a little about what the process of sex therapy can look like: 


Assessment and Beginning the Therapy Process 

  • Vaginismus requires looking at many components in your life and is often coordinated with a pelvic floor physical therapist and/or OBGYN to understand the potential underlying medical features. Sex therapy includes an assessment that explores family history, sexual history, and many other important pieces in your life. Uncovering contributors to vaginismus is an integral part of therapy. 

  • The assessment process is also a great time to discuss goals, fears, and any treatments you have already tried. This will ensure a personalized treatment plan and therapy that is tailored to fit with your unique self. 

  • Therapy works best with a therapist that you have a strong therapeutic relationship with. The right therapeutic fit is paramount to this work. You and your therapist should be able to check in on therapeutic fit, rapport, trust, and communication to ensure that therapy can be effective. 


Education 

  • Part of the work in sex therapy is learning about vaginismus, your body, sexuality, and both the physical and emotional aspects at play. This will involve psycho-education to increase knowledge and reduce fear, anxiety, and tension. 

Anxiety Management 

  • Anxiety and vaginismus can often form a feedback loop. If a penetrative event of any kind causes pain, this can lead to catastrophic thoughts, which can lead to even more muscle tightening and tension in the pelvic floor. 

  • Anxiety management techniques and mindfulness can help in breaking this cycle by identifying and challenging negative thought patterns related to intimacy, sexuality, and self-worth. 


Building a Support System 

  • Sex therapy often involves taking a multidisciplinary approach. Therapists often collaborate with gynecologists, pelvic floor therapists, and relationship therapists. 

  • They can also refer you to specific support groups. It’s important to understand that no one is alone in their experience with vaginismus. Talking to other people who experience this can normalize the experience and reduce shame and distress. 


Self-care and Patience 

  • Progress may be slow and require patience. Therapy will emphasize and provide tools for self-care, self-compassion, and patience as you embark on this vulnerable process.


Healing is a unique journey for each individual or couple. With the right guidance, support, and dedication, you can treat vaginismus and embrace a healthy and fulfilling relationship with your body.

 
 
 

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