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Treatment of Vaginismus and Vaginistic Reaction

Written by: Wendy Moelker, psychologist in charge of Emergis, Goes, the Netherlands and Kerstin Granberg-Lundgren, HudSTDkliniken AC NUS, Umeå.
First version: 22 Jul 2008. Latest version: 26 Aug 2008.

Abstract:

Treatment appropriate to different kinds of problems.

Question:

How can vaginismus, the vaginistic reaction, and vestibulit be treated?

Answer:

As explained earlier there are two sorts of vaginismus: primary and secondary.

Secondary vaginismus is easier to treat, because the problem has not been present since birth and the cause is often psychological. The kind of therapy depends on the causes of the complaint and the skills of the person in charge of the case. A combination of exposure, e.g exposing the woman to the feared situation with as little fear as possible, muscle and breathing training and improving the thoughts about sexuality and own body are, often used.

Sometimes dilators are also used. These are progressively larger objects that the woman inserts at home, step by step, while she relaxes her pelvic floor muscles. This will be explained and prepared in the therapy. The woman will become more familiar with her vagina and learns how to relax her pelvic floor muscles when something is inserted.

Women with vestibulitis should go to a clinic which specializes in the treatment of vulva problems. Such clinics sometimes have a gynaecologist, sometimes a skin doctor. It is very important to get to a clinic which has special competence on this specific problem. A combination of medical and psychological help is often needed.

Vestibulit is not always easy to treat. If a woman with vestibulit wants to try sexual intercourse, silicon-based lubricants are often better than water-based lubricants. Women with vagnismus need support in accepting the kind of sexuality which suits them. They need to know that it can be right to do without vaginal intercourse without having guilt feelings, and to experiment with other alternative ways of making love. Later on, they may be able to accept vaginal sex. For some women, help from a physiotherapist to learn to understand their bodies. Massage and acupuncture and similar treatments can sometimes also help.

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