W C M Weijmar Schultz and H B M Van de Wiel

Groningen University Medical Centre, Groningen, The Netherlands

Introduction 274

The Definition 274

Views on the Causes of Vaginismus 275

The Psychoanalytical View 276

The Behavioristic View 276

The Interactional View 278

The Sociocultural View 278

The Pain View 279

The Overactive Pelvic Floor Muscle View 279

The Somatic View 279

The Multidimensional View 280

Treatment for Vaginismus 280

Treatment Protocol 281

Introduction 281

Information About Vaginismus 282

Explanation of the Treatment 282

Physical Examination 283

The Context 283

Adequate Spreading 284

Measuring of Pain 284

The Pelvic Floor 285

Behavioral Therapy 286

Step 1: Self-exploration 286

Step 2: Systematic Desensitization 286

Step 3 Step 4 Step 5

288 288 289

Cognitive Therapy References

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