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Description:Treatment of vaginismus may involve the use Hegar dilators , sometimes called vaginal trainers [23] progressively increasing the size of the dilator inserted into the vagina. Although the pubococcygeus muscle is commonly thought to be the primary muscle involved in vaginismus, Pacik identified two additionally-involved spastic muscles in treated patients under sedation. This is due to the fact that women may not produce natural lubrication if anxious or in pain. This may be due to physical causes such as a yeast infection or trauma during childbirth , while in some cases it may be due to psychological causes, or to a combination of causes. In second degree, the spasm is present but maintained throughout the pelvis even with reassurance. Although no random controlled trials have been done with this treatment, experimental studies with small samples have shown it to be effective, with sustained positive results through 10 months.

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