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Dan, this is a very important post. Many men experience exactly what you describe. There seems to be no good answer until the vaginismus is cured, and even then there may be irreparable damage to the relationship. It is important that your wife complete the questionnaires (you may have to fill them out for her, sometimes women are unable to complete them, too much emotion attached) and that both of you spend time reading the book “When Sex Seems Impossible…” (can be ordered through my office or on Amazon.com). Severe vaginismus is diagnosed mostly by history, women who have the severe form are unable to be examined. Botox is used to overcome the muscular spasm usually identified at the time of treatment. Post procedure counseling is often a must after treatment to overcome relationship and libido lingering effects of vaginismus after treatment. It is not an easy path, but there can a rainbow at the end of all this if both of you are willing to do the work.