When we (Phil and Lorna Sarrel) worked as a sex therapy team, we treated more than 500 cases of vaginismus and the success rate was close to 99 percent. We say this, not to toot our own horns, but to emphasize how very effective the treatment is. We learned how to treat vaginismus from Dr. William Masters and Virginia Johnson, the team that invented the rapid approach to sex therapy. Their methods are still widely used.
Let’s talk to our imaginary couple, Jane and Tom. Jane and Tom, you may be wondering how you can confirm that Jane’s pain is actually vaginismus. You can see for yourselves at home or in the doctor’s office. Jane, you need to recline with your back at about a 45 degree angle, legs apart, knees bent so that your vulva (external part of female genitals) is visible. If you hold a mirror inside one knee you should have a clear view. Either Tom or the doctor then moves a hand toward your vulva. If you see that vaginal opening tighten in a clench or blink, that’s vaginismus.
Vaginismus is a learned or conditioned reflex. To treat it you must un-learn it. When vaginal penetration is about to happen, Jane, you will learn to relax and not be afraid. You will need to do some regular homework and you and Tom should not even try to have intercourse until near the end of therapy.
Jane, the homework involves your inserting a finger or two or inserting vaginal dilators (the preferred, simpler method). Look on the internet for “vaginal dilators.” You don’t need a set of 8 or 10; five, in graduated sizes from the narrowest, is enough. You’ll also need a tube of lubricating gel (not petroleum jelly). The depth of the dilators is unimportant. You are NOT trying to stretch yourself; you are retraining the muscles at the vaginal opening.
Jane, you’ll need to have private time for dilator insertion twice a day. Relax any way that works for you – music, exercise, yoga, meditation, deep breathing. Then, on your back at that 45-degree angle, insert the smallest dilator (or your index finger), lubricated, slowly and gently. Next, lay back and daydream, read or watch TV, for 45 minutes, with the dilator in place, as your vaginal muscles relax completely.Read more in Advancing Health After Hysterectomy