I have to write about vaginismus. It’s a condition where a woman can’t get a penis into her vagina. It can be mild…so mild that often-time she can get a penis in the vagina for very short periods but it’s unpleasant and painful. Or it can be severe, so severe, she can’t touch herself near her vagina,can’t have a gynecological exam, can’t insert a tampon.

It is one of the most devastating conditions we see in patients. Not becaus ethe absence of intercourse is by definition the loss of a sex life. But these women start to think that there is something crazy and abnormal about them. They start to feel horrible about themselves. They start to avoid any sexual encounters with partners. Some even go so far as to stop dating altogether.

Seeing vaginismus patients has become a large part of our practice. I used to think it was much rarer than I do now. My heart breaks for these patients. Part of the problem is psychological, they are uptight, scared, anxious, petrified. Much of the problem is physical. Their vaginas are tight and there is pain. What always strikes me is how much avoidance these women exhibit. They have every excuse in the book why they haven’t dealt with the problem, can’t deal with it now, and can’t do excercise. The physical part of it is very treatable, if they don’t run away petrified. And no. I haven’t seen a correlation with sexual abuse.

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