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    Dr. Pacik

    I recently treated 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.

    What is the experience of others to “disgust”? If this was a problem how did you overcome this or is it still lingering? This is a very important topic, and I would appreciate the feedback of others.


    Hi Dr. Pacik. While I haven’t experienced this personally, I believe that “disgust”, like low-libido, anorgasmia, etc. is a common condition that can co-occur with vaginismus. My first piece of advice to this person is to please know that you are not alone in your feelings and so many others have felt similar to you. Secondly, I would like to congratulate you on having the procedure and your tremendous success and progress in overcoming vaginismus and having pain-free intercourse. This is wonderful! Just like overcoming the physical pain, I KNOW that you will be able to overcome the emotional pain as well and have pleasurable intercourse.

    Darcy, a certified sex therapist in NH, wrote a great post that you may find helpful:

    “For the women that I see in my sex counseling practice, it helps to build positive sex memories and to focus on communication with your partner. Using fantasy and connecting sound, touch, taste, smells, and images to the sexual experience can also aid. The images, smells, etc don’t even have to be sexual. If fresh baked cookies make you smile and feel warm and gooey inside or an image of green grass swaying in a field relaxes you, focusing on those things during foreplay or while masturbating will help to create new “memories” that will start to elicit those same warm gooey feelings with sexual touch. Before you know it, sex and sexual touch start to bring on those same emotions. Knowing your own body and how it reacts to various touch and stimulation are also very critical to helping to share that experience with someone else.”

    What further advice do you have here ladies? Your comments and feedback would be very helpful.

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