ABSTRACT
Introduction 274
The Definition 274
Views on the Causes of Vaginismus 275
The Psychoanalytical View 276
The Behavioristic View 276
The Interactional View 278
The Sociocultural View 278
The Pain View 279
The Overactive Pelvic Floor Muscle View 279
The Somatic View 279
The Multidimensional View 280
Treatment for Vaginismus 280
Treatment Protocol 281
Introduction 281
Information About Vaginismus 282
Explanation of the Treatment 282
Physical Examination 283
The Context 283
Adequate Spreading 284
Measuring of Pain 284
The Pelvic Floor 285
Behavioral Therapy 286
Step 1: Self-exploration 286
Step 2: Systematic Desensitization 286
Step 3 287
Step 4 287
Step 5 288
Cognitive Therapy 288
References 289
INTRODUCTION
Vaginismus is defined as recurrent or persistent involuntary spasm of the muscu-
lature of the outer third of the vagina that interferes with vaginal penetration,
which causes personal distress (1). Vaginistic women vary widely in their
sexual behavior repertoire: from very limited to very extensive. In some cases,
the desire to have children is first and foremost, without there being any real
motivation to work on the sexual relationship. The complaint can be situational
or generalized. Vaginismus is not part of the sexual response cycle.
