Vaginismus is a condition that affects many individuals. It is characterized by involuntary muscle contractions in the pelvic floor, which can make vaginal penetration painful or impossible. Not only can this reduce sexual satisfaction, it can interfere with medical care.

Vaginismus is believed to be underdiagnosed due to many people with vaginas being unwilling to discuss their symptoms, or their symptoms may be minimized by health care providers. Nonetheless, vaginismus is a real and treatable condition and seeking help is a brave step towards its treatment. 

The therapists at New Moon Psychotherapy understand vaginismus and its treatment and are here to provide information, support, and hope. We work with cis-gender, trans, and non-binary folks. This page discusses the potential causes of vaginismus and how psychotherapy can be a valuable tool in its treatment. 

What are the Causes of Vaginismus?

Vaginismus is characterized by involuntary muscle contractions in the pelvic floor, which can make vaginal penetration painful or impossible. While the exact cause can vary from person to person, here are some potential factors contributing to vaginismus:

Emotional Factors

Past traumatic experiences, anxiety, fear of pain, or negative beliefs about sex can trigger vaginismus.

Physical Factors

Certain medical conditions, infections, or surgery in the pelvic area may contribute to vaginismus.

Relationship Issues

Problems in a relationship, communication difficulties, or a lack of trust and intimacy can play a role in vaginismus.

Psychological Factors

Stress, depression, or a history of sexual abuse can exacerbate the condition.

How Can Therapy Help?

Psychotherapy, specifically cognitive-behavioral therapy (CBT) and sex therapy, can be instrumental in treating vaginismus. Here’s how it can help:

Identifying Triggers

A trained therapist can help you explore the emotional and psychological factors contributing to vaginismus. This process can provide valuable insights and relief.

Coping Strategies

Therapy equips you with effective coping strategies to manage anxiety, fear, and pain associated with vaginal penetration. You’ll learn relaxation techniques and how to reframe negative thoughts.

Desensitization Exercises

Gradual exposure to vaginal penetration, under the guidance of a therapist, can help reduce the body’s reflexive response and make intercourse less painful.

Trauma Processing

Traumatic experiences, whether related to sexual abuse, relationship conflicts, or other life events, can have a profound impact on one’s sexual function. These traumas can lead to anxiety, fear, and negative beliefs about sex, which can cause tension. Sex therapy may involve various forms of therapy to help you process your past traumatic experiences. These therapeutic approaches may include Cognitive Processing Therapy (CPT), Eye Movement Desensitization and Reprocessing (EMDR), Emotion Focused Therapy, and Psychodynamic Psychotherapy. 

Enhancing Communication

Couples therapy can be beneficial if vaginismus is affecting your relationship. Improved communication and intimacy can help reduce anxiety and build trust.

Boosting Confidence

Therapy can boost your self-esteem and self-confidence, which is vital for overcoming vaginismus.

Medical Integration

Psychotherapy can complement medical treatments, such as physical therapy or medications, to improve overall treatment outcomes.

What Can I Expect During Sex Therapy for Vaginismus?

Sex therapy provides a safe, supportive, and non-judgmental space in which you can openly discuss your concerns and past experiences. Sex therapists have specialized training in sex issues and sex therapy for vaginismus.   

Here’s a list of what you can typically expect during sex therapy for vaginismus.

Compassion and Understanding

At New Moon Psychotherapy, we understand that vaginismus is a painful, distressing, and challenging condition both physically and emotionally. This understanding is conveyed through compassionate and non-judgmental support.

Personalized Assessment

The first one to three sessions involve a personalized and comprehensive assessment to help your therapist understand the physical, emotional, and psychological factors contributing to your experience with vaginismus. The therapist will ask you questions about your medical history, sexual history, relational history, and any emotional or psychological factors. 

Part of the assessment involves goal setting. This information is used to inform your tailored treatment plan.

Education

Part of therapy involves learning about and understanding vaginismus, its potential causes, and the treatment options that are available to you. It is important that you understand your condition and how it manifests and is maintained in order to understand how to treat it. 

Often, sex therapists will correct misinformation about sex and sex functioning which may have contributed to or maintained vaginismus and which are interfering with a pleasurable and fulfilling sex life. 

Identifying Triggers

During sex therapy you will explore emotional, psychological, and situational triggers that may be contributing to vaginismus. Once you identify triggers, you will be able to learn to respond differently to them.

Coping Strategies

A component of sex therapy is learning effective coping strategies to manage anxiety, fear, and pain associated with vaginal penetration. These techniques may include relaxation exercises, exercises to regulate your nervous system, mindfulness, and desensitization exercises, which gradually reduce your body’s response.

Gradual Exposure

Sometimes therapy for vaginismus involves gradual exposure exercises which slowly increase your comfort with vaginal penetration. You will carry out the exercises privately, at your own pace, to ensure that you are comfortable and in control of your progress. 

The therapist will provide instruction and you will discuss your experiences with the exercise with the therapist. 

Relationship Support

If vaginismus has affected your relationships, therapy may involve couples therapy to help your partner understand your condition and how they can support you. Couples therapy can improve communication, intimacy, and trust between you and your partner which has been associated with improved sexual functioning.

Progress Monitoring

Throughout the therapy process, your therapist will monitor your progress towards your treatment goals. They will make adjustments to the treatment plan to ensure that you’re on the right track and that the treatment plan is suitable to you. 

Emotional Support and Encouragement

One of the most important aspects of sex therapy is providing you with emotional support and encouragement. You will find a non judgmental, empathic, and understanding environment where you can openly discuss your concerns and experiences. It is normal to feel uncomfortable talking about sex and sex related difficulties. This gets easier with time. 

Duration and Frequency

The number of sessions and their frequency can vary depending on your individual needs and progress. Some people may benefit from a relatively short-term therapy approach, while others may require longer-term support. 

Confidentiality

Therapists that offer sex therapy are regulated health professionals. This means that all sessions are conducted in strict confidence. Your privacy is a top priority in sex therapy. The sex therapist will help you understand limits to confidentiality at your first appointment. 

Overall, sex therapy for vaginismus aims to provide you with the tools, knowledge, and support that will help you overcome this difficulty and improve your sexual health and satisfaction. It is a collaborative and empowering process which will move you towards a more satisfying and fulfilling sex life.