Vaginismus: a review.

Vaginismus includes both physical as well as psychological aspects that make vaginal penetration extremely painful if not altogether impossible. Aside from history, diagnosis rests on the physical examination. The causes for the condition range from the deeply psychological to vividly recalled genital experiences and may involve conditioned responses. Similarly, treatment methods range from surgery to simple muscle-strengthening exercises to elaborate psychotherapeutic intervention. More recently, behavioral methods have shown marked success. The most important considerations in therapy seem to be the patient's understanding of the problem and flexibility of approach.