I am following a 23 year old with a seven year history of severe vaginismus who was sexually molested at the age of 15. She had numerous attempted treatments to overcome her vaginismus that included physical therapy with biofeedback, Kegels, and dilators; muscle relaxants, lubricants, topical anesthetics and self induced excess alcohol use, all to no avail. She was noted to have maximum spasm of the entry muscle on examination. By about 5 days she reported no pain when using the largest #6 (blue) glass dilator but continued anxiety (4 on a scale of 1-10). She achieved pain free intercourse 10 days after treatment with the Botox program.
She has mailed me her dilation log daily and I noted the excellent progress she was making. Nevertheless her “disgust” to intercourse continues and this is very upsetting to her. She is afraid she will not be able to overcome this.
It is important to be aware that there can be both a physical block (spasm of the entry muscle that results in an uncontrollable, involuntary inability to have intercourse), and in this situation a psychologic block (“disgust”) that is also involuntary and out of a woman’s control. This appears to represent a psychologic defense mechanism to protect oneself against the anticipated pain of intercourse. When a woman is able to embrace this concept that there is a both a physical block and a psychologic block (disgust) beyond a person’s control, then just by understanding the dynamics of what is taking place, can be the beginning of overcoming this very uncomfortable situation. Added counseling by a trained therapist can also be of great value.
The concept of disgust with intercourse was posted on the Forum for those who want to follow this thread. Considerable information can be found in the scientific literature regarding this little discussed topic.
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