A Cochrane review found little high quality evidence regarding the treatment of<unk>  in 2012. Specifically it is unclear if systematic desensitisation is better than other measures including nothing. Psychological According to a 2011 study, those with<unk>  are twice as likely to have a history of childhood sexual interference and held less positive attitudes about their sexuality, whereas no correlation was noted for lack of sexual knowledge or (nonsexual) physical abuse. Somatic experiencing sessions can help heal any body-related trauma. Physical Dilators for treating<unk>  Often, when faced with a person experiencing painful intercourse, a gynecologist will recommend reverse Kegel exercises and provide some additional lubricants. Although<unk>  has not been shown to affect a person's ability to produce lubrication, providing additional lubricant can be helpful in achieving successful penetration. This is due to the fact that women may not produce natural lubrication if anxious or in pain. Achieving sufficient arousal during foreplay is crucial for the release of lubrication which can contribute to the ease of sexual penetration and pain-free intercourse. Though strengthening exercises such as Kegel exercises were previously considered to be a helpful intervention for pelvic pain, new research suggests that these exercises, which function to strengthen the pelvic floor, may not be helpful or may make conditions that are caused by over-active muscles such as<unk>  worse. Exercises that stretch or relax the pelvic floor may be a better treatment option for<unk> . To help develop a treatment plan that best fits the needs of their patient, a gynecologist or general practitioner may refer a person experiencing painful intercourse to a pelvic floor physical therapist. These therapists specialize in the treatment of disorders of the pelvic floor muscles such as<unk> , dyspareunia, vulvodynia, constipation, and fecal or urinary incontinence. After performing a manual exam both internally and externally to assess muscle function and to isolate possible trigger points for pain or tightness on the muscles, pelvic floor physical therapists develop a treatment plan consisting of muscle exercises, muscle stretches, dilator training, electrostimulation, and/or biofeedback interventions. Treatment of<unk>  often involves the use Hegar dilators (sometimes called vaginal trainers), progressively increasing the size of the dilator inserted into the vagina. The game-changing technique is to practice conscious diaphragmatic breathing (breathing in deeply allowing one's belly to expand) and allowing the pelvic floor muscles to lengthen during inhale; then exhale, bringing belly in and repeat. This technique would effortlessly slide the dilator in. Research suggests pelvic floor physical therapy is one of the safest and most effective treatments for<unk> . Neuromodulators Botulinum toxin A (Botox) has been considered as a treatment option, under the idea of temporarily reducing the hypertonicity of the pelvic floor muscles. 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. Similar in its mechanism of treatment, lidocaine has also been tried as an experimental option. Anxiolytics and antidepressants are other pharmacotherapies that have been offered to people in conjunction with other psychotherapy modalities, or if these people's experience high levels of anxiety from their condition. Evidence for these medications, however, is limited.
Vaginismus
Dyspareunia
Anismus
Geniospasm
Trismus
Facial weakness
Carotidynia
Paronychia