Abstract
A 23-year-old woman was referred by her gynecologist with severe vaginismus 6 months after her wedding. She was unable to tolerate sexual intercourse, insertion of tampons, orpelvic examination, while also demonstrating mild to severe anxiety to many forms of “penetration,” including injection, brushing her teeth, or even watching such activities on TV. She was otherwise comfortable and responsive in other sexual situations and was highly motivated to succeed in therapy. No vaginal penetration was achieved after 10 psychotherapy sessions at which point medications were recommended. Within two therapy sessions following initiation of anxiolytic medication, significant progress was noted, and after 13 sessions, sexual intercourse was successfully completed and continued after discontinuation of all medications. Anxiolytic medication may be a useful adjunct to psychotherapy when vaginismus is accompanied by symptoms of severe anxiety or panic.