Vaginismus, sometimes called vaginism, is the result of an involuntary vaginal muscle spasm which makes any kind of vaginal penetration, including manual penetration, insertion of tampons or sexual intercourse painful or impossible. Often, the penetration involved in gynecological examinations is also impossible. [1] [2]

Types
While primary vaginismus is discovered in girls as from birth, secondary vaginismus often occurs in the course of a lifetime. It may be due to psychogenic causes such as sexual phobia, a strict sexual morality or sexual traumas. [2] [3]

Treatment
Botulinum toxin A (Botox) has been considered as a treatment option, under the idea of temporarily reducing the hypertonicity of the pelvic floor muscles. It has an effect of 3 months. [2]

Therapy consists of two parts. Firstly, in the context of a conversational therapy, causing factors are explored and attitude towards pleasure and sexuality is reflected. Secondly, the woman concerned is advised to become an expert of her own body, and to discover it in her own pace. The sensual touching of vulva and vagina may eliminate a reflexive vaginismus bit by bit. Once the manual penetration is possible, the sexual partner can also be involved. In the end, the insertion of a sex toy or sexual intercourse may be tried out. In any case, a mindful and relaxed procedure is important in order to gradually relieve the (unconscious) fear of penetration. [1] [2] [4]

Many women regain control over their own body by means of a sexual medical therapy. The new autonomy and body competence are experienced as rewarding. [1]