Vaginismus and GPPPD impacts women, her partner and the couple’s relationship in many different ways. Embracing a holistic and integrative path for resolving vaginismus with the support of an experienced therapist will give you the confidence to respect and accept your body as it is right now and move forward with a positive perspective.              

Recent research ‘Vaginismus in the Irish Context by Maria McEvoy’ published in 2021 highlights there are many presenting challenges for the women and couples seeking treatment for vaginismus, which is a genito-pelvic pain/penetration disorder (GPPPD). These include a lack of public health services, insufficient psychosexual therapists, absent professional training, and a lack of clear treatment programmes and services for conditions such as vaginismus and penetration disorders across Ireland.

These factors stress the need for trained, experienced psychosexual therapists who also work with couples that can provide an integrative approach to treating vaginismus within a clinical, multidisciplinary, public, or private capacity. As well as provide services such as face-to-face or online therapy, which should both be financially viable and accommodating of those restricted geographically. McEvoy’s (2021) research identified that women and couples experiences of therapy and intervention for vaginismus was mixed, but where it had been successful it was due to the sense of a nurturing and supportive connection with their therapist. Read more about the impact of vaginismus on the women, her partner and the couple.

As a Psychotherapist who specialises in sexology and with a background in complementary health therapy, I believe that when services such as these are limited it highlights the importance of having a holistic and integrative programme to follow with the support and reassurance of a therapist, which you can also focus on and implement in a wholistic way – in your own time, independently and with the support of other professionals and your partner.

Many of the women and couples in this study said that therapy had been successful because they had a connection with their therapist that was perceived as nurturing and supportive.’ (McEvoy 2021)

What are effective interventions for vaginismus?

There are a number of evidence-based effective interventions for women with penetration disorders. A knowledgeable psychosexual therapist can provide suggested interventions and continuous guidance and support to her clients. If you would like to book an appointment to discuss how I can help and support you and your partner with vaginismus click here.

Listed below are some evidence based interventions for the treatment and resolution of vaginismus and penetration disorders for both women and couples which you may find helpful. With the support and guidance of your therapist, together you can understand which interventions may work best for you using a gentle holistic and integrative phased approach.

• Psychosexual Therapy For Couples – Sex therapy for couples explores the diverse aspects of sex, intimacy and sexuality within the couple’s context. Therapy will assess in detail all aspects of the presenting problems, vaginismus symptoms, including taking into consideration sex education, beliefs, childhood trauma, attitudes to sex, sexual shame, cultural and religious factors and the desires and needs of each individual couple.    

• Sensate Focus For Couples – Sensate Focus in Sex Therapy – The Illustrated Manual by Weiner & Avery-Clark (2017) may be used by practitioners for many reasons. Primarily to help identify psychological, relational, lifestyle and sociocultural issues which contribute to the sexual problem while also teaching new skills to remedy sexual issues, facilitate satisfying and meaningful sexual intimacy between a couple. It provides two guides which may be used for the resolution of vaginismus;
  • Sensate Focus 1 Instruction for Clients (Weiner et al., 2017:134)
  • Sensate Focus Special Instructions and Modifications for Different Dysfunctions (Weiner et al., 2017:137)

Mindfulness based exercises – help the female to learn how to be present in her own bodily sensations (Brotto 2018) and develop a deeper more intimate awareness of self through mindfulness exercises and practices.  The purpose of mindfulness is to encourage connection and awareness within the body rather than a disconnect, detachment or dissociation from her body.

“Mindfulness is an attitude of here-and-now, self-focused awareness during which each sensation, emotion, intuition, thought, and feeling that captures your attention is acknowledged and accepted just as it is without judgement and evaluation.” (Weiner et al 2017:14)

• Anxiety management – an anxious disposition, anxiety, and sexual anxiety are prevalent in women with vaginismus, thus, anxiety management tools, exercises, and strategies will be beneficial.

• Behavioural exercises – such as developing sexual self-esteem, improving body confidence, exploring and looking at ones own body and genitals. Practising self-touch, self-sensate focus, self-exploration, self-soothing exercises, and sensual touch. Learning how to adapt a sex positive attitude to sex and intimacy.

• Physical exercises – Pelvic floor exercises, pelvic stretches, and kegels are beneficial for pelvic floor hypertonicity and may help to reduce tension in the pelvic and vaginal region. These can be self-practised or with the support of a personal trainer or Physiotherapist who has knowledge of GPPPD.

• Behavioural exercises – such as developing sexual self-esteem, improving body confidence, exploring and looking at ones own body and genitals. Practising self-touch, self-sensate focus, self-exploration, self-soothing exercises, and sensual touch. Learning how to adapt a sex positive attitude to sex and intimacy.

• Psychosexual education – sex education and sexuality education particularly relating to reproductive anatomy and physiology and importantly developing a deeper understanding and awareness of the male and female sexual arousal response cycle.

• Dilator Training (DT) and Finger Training (FT) – are physical self-exercises that help women to practice vaginal penetration using a gentle phased approach over a period of time. Dilator training is to dilate, stretch, tone and loosen vaginal muscles. Research (Molaeinezhad 2014) shows that women were much more successful and engaged with dilator training than finger training and that the finger training cohort had a significantly higher dropout rate than those women who practiced using dilators. Read my article everything you need to know about choosing a dilator for dilator training to learn more.

• Sexual wellbeing products – such as dilators, Kegel balls, vaginal trainers and clitoral stimulators can be beneficial for women who experience painful sex and who wish to develop enhanced sexual responses, sexual self-esteem, and sexual desire with or without the intention of vaginal penetration. 

• Specialist Pelvic Physiotherapists – provide physical therapy and rehabilitation for women with vaginismus and GPPPD and may be part of an integrative programme. Physiotherapists will provide consultation, assessment, treatment and exercises.

Your therapist may suggest and explore implementing any number, or combination, of these evidence-based interventions within your programme as they all have their own unique advantages. It is important to have a clear treatment plan with goals in place for resolving vaginismus to keep you focused and motivated.    

Rest assured that, with the right psychosexual therapist on your side, any assessment, interventions and practices put into place throughout your programme will be discussed, agreed upon, gradually introduced, and entirely purposeful to your, your partner’s, and your relationship’s overall growth. Women who are ready to address this condition for the first time with the right support can move from powerlessness to empowerment.

Embracing a holistic and integrative path for resolving your vaginismus will not only allow you to manage vaginismus but ultimately help you develop a deeper awareness, understanding and acceptance of your own beautiful and authentic self.

You might be interested in reading these interesting articles about vaginismus;

Getting help for vaginismus and moving from powerlessness to empowerment

Everything you need to know about choosing a dilator for dilator training

The impact of vaginismus of the woman, her partner and the couple