Sexual Dysfunction

Vaginismus is a condition in which intense fear during intercourse causes the muscles at the entrance to the vagina to contract, so that intercourse becomes impossible or very painful. Underlying the fear is the thought of facing something unmanageable: that the vagina is too small, that it will hurt a great deal, that there will be tearing. Over time, being unable to have intercourse can lead to erectile difficulties and loss of desire in the partner. With the right specialist and the right behavioural therapy, the chances of successful treatment are high.

Not being able to achieve an erection sufficient for intercourse is defined as erectile dysfunction. An erection is a physiological process that follows sufficient arousal, and many factors can interrupt it. When an erection affected by tiredness, low desire or excitement is joined by the thought of failing, anxiety takes hold. In most cases this can be resolved by therapy alone, without medication: the aim is to move attention away from the anxiety and back towards arousal.

This describes ejaculation that the man cannot prevent at the very beginning of intercourse, against his wishes — before penetration or very shortly after it. The timing of ejaculation is something that is learned. Treatment aims to identify the stimuli that bring the person to the threshold of ejaculation and, with behavioural exercises that reduce exposure to them, to establish control. Help should be sought from a qualified sexual therapist.