性功能障碍的诊断与治疗-性治疗

阴道痉挛: 可能的病因
在少数罕见的病例，阴道痉挛因为早前的性行为体验到的疼痛所发展出的保护性反应；这种疼痛由某些外伤或内部性器官的疾病所导致。显而易见，需要对这种病例所遭受的躯体病因进行治疗。
可是，阴道痉挛十分常见的病因完全是心理性的。例如，这个女子从前可能遭受过性创伤体验(traumatic experience)，譬如被强奸或与一位粗心大意的性伴性交等等。在开始任何的性治疗之前，务必要先关注这样的性创伤体验。
也可能有较为简单的病因解释：自己的性伴不能进行性交或维持勃起的女子可能最终对他性交时徒劳的插入尝试感到灰心和忧虑，以至于她的阴道不由自主地紧闭起来。另一方面，甚至一位有着正常性反应的男子如果总是遇到这个女子的阴道过紧而不能插入，最终可能也会发生性功能障碍。所以，一对性伴也许会陷入相互失望的恶性循环怪圈。这样一来，功能障碍是怎样开始的也就没有什么大的差别了。男女双方也都需要进行治疗。
阴道痉挛的另一个可能病因是训导女孩认为性是肮脏的或邪恶的清规戒律式养育方式。这样的负面态度根本上可以非常有效地压抑女孩的性机能。

The Treatment of Sexual Dysfunctions - Sex Therapy

The “Classic” Dysfunctions - The Treatment of Female Sexual Dysfunctions

Vaginismus: Possible Causes
In a few rare cases, vaginismus develops as a protective reaction against previously experienced pain during sexual intercourse which, in turn, was caused by some injury or disease of the internal sex organs. Obviously, in such a case, the underlying physical cause must be treated.
However, very often the causes of vaginismus are entirely psychological. For example, the woman may have had some traumatic experience such as rape or coitus with an inconsiderate partner. Such experiences must be addressed before any treatment can begin.
There may also be a simpler explanation: A woman whose partner is unable to have or hold an erection may eventually become so frustrated and apprehensive about his futile attempts at coitus that her vagina tightens involuntarily. On the other hand, even a man with healthy sexual responses may eventually become dysfunctional if he always finds the woman's vagina too tight for penetration. Thus, a couple may enter a vicious circle of mutual disappointment. It then makes little difference how the problem began. Both the man and the woman need treatment.
Another possible cause of vaginismus is a strict and puritanical upbringing that teaches a girl to consider sex dirty or evil. Such negative attitudes can very well prevent her from functioning sexually at all.