First we want to understand the causes of the tightening up of the vagina, so a full discussion is important before embarking on any treatment. Also talking together allows the woman and the therapist to get used to each other, and builds a trust between them, which is necessary in this type of work.

Some of the common causes for this troublesome condition are:
· Lack of knowledge, wrong beliefs, strict upbringing,
· Past infection, trauma, or injury in the genital area,
· Difficult relationship with your partner,
· Concerns about intimacy or commitment,
· Difficult childbirth or genital surgery,
· Sexual trauma.
All these can be discussed and helped before doing any physical work.

Sometimes there are deeper reasons, and therapy, counselling or hypnotherapy would help with these. There may have been Sexual Abuse which would need extra time and care to recover from.

In treatment, the vagina has to be taught to become less tense, by accepting touch on the outside at first, then gradually a cotton bud, finger or small trainer on the inside. Larger Vaginal Trainers can then be introduced. When the vagina can accept all sizes of trainers, it is usually able to relax sufficiently to have intercourse, and Sex Therapy helps with this.

Very often, the woman needs help from the therapist to get this physical aspect to the treatment going. Working together with the woman on a couch, the therapist will encourage and help the woman to put a finger or cotton bud in the right place. Sometimes a therapist may have the appropriate training to use her own finger to assess the amount of spasm, and to gently massage the tight muscles so they can accept fingers or trainers more easily. Once the woman has enough confidence to use the trainers at home, then progress is much faster, as she does all the work herself in her own home and in private. Gaining this confidence, however, can take many weeks, so it is important to approach treatment with an open mind as to how it should go and how long it might take.

Some women are helped enough in just one or two session, others need many months or even years to overcome their problem.