Susanna is from South America, aged 25, living with her English boyfriend, Peter. She is unable to have intercourse because her vagina tenses up. She has no pain on attempts at penetration, because she never lets it get that far. This is her first sexual relationship, she thinks she is a late starter. They have sexual contact twice a week, but Susanna is terrified of the pain she is convinced she will feel if they have intercourse. There was nothing in her life story to account for her difficulty, so she agreed with me that together we would assess the tension in her vagina at our next meeting.

She felt relieved to have talked and was pleased that there was a way forward. On the couch, to her astonishment, she found she was able to touch her vaginal entrance with no pain, but was afraid to try to insert her finger. I suggested we do more next time. On her third visit, she managed to get one finger into her vagina, but there was no space for anything more. By squeezing and relaxing the muscles at the entrance to her vagina, Kegel's Exercises, she could gradually feel the space becoming bigger. By her next visit, after gently massaging the muscles inside the vaginal opening, she was able to use Vaginal Trainers.

Susanna used the trainers three times a week for 15 minutes, at home. In this way, her vagina slowly got used to having something inside and not going into spasm. One day she realised that there was no more fear. Then she had to learn to have intercourse.

Peter, her boy friend , was a gentle, understanding man, who was able to take time with Susanna. They agreed to have 'practice sessions' twice a week, and do Sex Therapy together. At the last stage, he introduced his penis, one inch at a time and did not thrust. Once Susanna could accept the whole penis, he began to thrust slowly. When Susanna was OK with that, the couple agreed to have full intercourse.