Vaginismus is a condition in which involuntary spasms of the vaginal muscles prevent vaginal penetration. A central issue is a woman’s fear that penetration of her vagina will hurt.
Understanding your anxiety is central to overcoming vaginismus, which is one of the most treatable sexual problems a person can have — if you do not let anxiety about pain, and avoidance of pain, control your response to it.
I have rarely failed to solve a woman’s problem with vaginismus. The only case in which I was not successful involved a patient who refused to perform the exercises she was assigned.
I treat vaginismus using dilators. The main reason a patient might have trouble overcoming vaginismus is that she avoids working with the dilators out of fear of experiencing pain.
(If you think you may have vaginismus, see a medical provider, because a physical examination is a necessary part of the diagnosis. There is another condition that needs to be ruled out.)
Most women who come to me need the one-on-one coaching of sex therapy to overcome vaginismus, because they need reassurance that the pain they are feeling is not a sign of some kind of danger.
When you are working with dilators, the pain is a sign that you are attacking the problem head on. It’s a sign of victory, not danger. It addresses anxiety over pain head-on.
It helps to conceptualize what you are doing with the dilators as retraining your body.
I work a lot with imagery; this is true of my work with vaginismus patients as well.
For instance, if you call up an image of a bodybuilder, that can help you gain strength and determination. When we think of bodybuilders, we picture them straining mightily, trying to transform their musculature. They don’t pick up the weights that they have already mastered. They are stressing and straining to pick up a weight that is heavier than what they have mastered already. You can see on their faces that they are experiencing pain.
The difference is that they view the pain as their friend, because the pain will let them get to their goal of building their muscles.
That’s exactly what patients have to picture as they do exercises with dilators.
Trust me, as you gain mastery and steadily work up from a small dilator to a larger and larger one, you will feel a great sense of command over your body and over your sexual life.
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