Vaginismus may impede orgasm in some cases.
The inability to achieve orgasm may relate to vaginismus. In some cases, vaginismus impedes orgasm through blocking penetrative intercourse or by causing pain during thrusting. Although vaginal penetration is not necessary in order to achieve orgasm, if the body reacts to stimulation by triggering the vaginismus response, the tightened pelvic floor may abruptly end arousal and even impair the ability to achieve orgasm manually. Also, any emotional issues contributing to the vaginismus response could also be impairing relaxation and the ability of a woman to allow the arousal cycle buildup to orgasm. For example, some women have anxieties related to being naked or vulnerable, and this could impair their ability to become aroused to the point of orgasm. Note that this is not universal. Many women with vaginismus have no trouble at all achieving orgasm.
A systematic approach to problems with orgasm are helpful, as there are many reasons why orgasm difficulty could be taking place. Women are encouraged to try to determine the nature of the difficulty with orgasm, if it is related to any emotions, anxiety, physical pain, or medication use. The self-help sexual history inventory in Step 2 of the vaginismus program may be helpful to identify any specific sexual fears or emotions that could be contributing to the problem.
If the vaginismus response is preventing orgasm, women may wish to try eliminating anything that could potentially trigger the pelvic floor tightening response, especially any perceived potential of intercourse. Most women with vaginismus (whether or not penetration is possible) are still able to have manual or non-penetrative orgasms, while they continue working to overcome vaginismus. Later, when pain-free intercourse becomes a reality, transition time for practice and experimentation may be necessary to achieve intercourse accompanied with orgasm. After pain-free intercourse is proceeding, some women may continue to prefer to have orgasms separate from penetrative intercourse during other phases of lovemaking. Not all women are able to have orgasms during intercourse even when vaginismus is not present. Only approximately one-third of women experience orgasm routinely during intercourse.
Finally, if the problem is unrelated to vaginismus, couples may want to read up on the subject to learn better techniques at lovemaking. There are many books on sex and intimacy that discuss orgasm issues and techniques to help achieve orgasm.
For more information about female orgasm issues see the helpful article "Female Orgasms Myths & Facts" at www.sogc.org.
"I can recommend use of this resource by all patients with vaginismus" - APTA Journal of Women's Health Physical Therapy
- Beth Shelly, PT, BCIA-PMDB