Therapist-Assisted Support for Vaginismus

December 15, 2025•3 min read

For women with vaginismus, pain, fear, and tension can make even a routine pap feel impossible. The shame and stigma associated with her suffering affect her approach to intimacy, medical care, and her sense of herself as a woman.

This week at Health Youniversity, we spoke with Dr. Kayla Jimenez, a clinical psychologist who helps women heal from vaginismus through a therapist-assisted exposure process. Her work offers both guidance and a safe space for women to heal their relationship with their bodies.

What is Vaginismus?

Vaginismus is a condition where involuntary contractions of the pelvic floor muscles make sexual activity, medical exams, or even tampon use painful or impossible. These challenges often first appear during adolescence, such as with a first pap smear or early sexual experiences, and can persist for years if unrecognized, affecting intimacy, self-perception, and overall well-being.

Factors Contributing to Vaginismus

Sexual Trauma: Some women develop secondary vaginismus as a response to past sexual trauma. Even after trauma-focused therapy, lingering fear or discomfort can contribute to involuntary muscle tension.
Social and Cultural Messages: Implicit or explicit messages of shame, stigma, or fear about women’s bodies can intensify avoidance and emotional distress.
Psychological Tendencies: Personality traits such as perfectionism, high achievement, and anxiety can heighten the body’s physical responses, making it harder to relax during intimate or medical experiences.

Vaginismus & Intimacy

Vaginismus affects sexual intimacy, though experiences vary widely. Some women are able to enjoy closeness and satisfaction without penetration, finding alternative ways to connect with their partners that avoid pain and anxiety.

Beyond the physical challenges, vaginismus often carries a heavy emotional burden. Women may experience shame, isolation, and frustration, feeling disconnected from their own bodies and their ability to fully engage in intimate relationships. Dr. Kayla notes that these struggles are frequently compounded by societal stigma, leaving many women unrecognized and unsupported for years.

Therapist-Assisted Exposure for Vaginismus

Therapist-assisted exposure is a structured, guided approach to reduce fear, tension, and pain associated with vaginal penetration. Under a trained clinician’s guidance, women progress through gradual exercises combined with real-time emotional processing.

Careful pacing and ongoing therapist support provide safety. Treatment is often interdisciplinary, involving collaboration with pelvic floor therapists, OB-GYNs, and fertility teams, addressing both physical and emotional aspects of vaginismus.

Therapy is individualized, with self-guided exercises complemented by therapist support. It ranges from 8 to 20 sessions, scheduled weekly, bi-weekly or monthly. Home exercises and pelvic floor exercise, complement session work, building confidence and progress.

Access to Vaginismus Treatment

Therapist-assisted exposure is mainly available in California (Stanford and select private practices). Women elsewhere can access support through consultations, local pelvic floor therapists, OB-GYNs, or evidence-based therapy.

Internationally, programs in the Netherlands and Canada demonstrate successful integration of therapist-assisted approaches, offering potential models for expanding access in the U.S. and recognizing vaginismus as a treatable condition.

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Dr. Kayla Jimenez is a women’s mental health expert, guiding women through vaginismus with understanding and practical support. Drawing on her clinical experience and her Therapist-Assisted Exposure workshop, she combines education, therapy, and empowerment to help women reclaim control over their bodies and intimate lives.

Website: https://www.palmettopsychology.com/
LinkedIn: https://www.linkedin.com/in/kayla-jimenez-psy-d-220774227/

Medical Disclaimer:

By listening to the Health Youniversity podcast, you agree not to use this podcast as medical advice to treat any medical condition for yourself or others. Consult your healthcare provider for any medical issues you may have. This entire disclaimer also pertains to any guests or contributors to any Health Youniversity podcast.

Dr. Susan Fox

I am a women’s health expert with a specialty in working with women and couples navigating fertility challenges for more than 20 years. I look forward to helping you realize your dream of family. I’m also a mother, a sister, a friend. I live in beautiful Northern California, where the nature of Mt. Tamalpais, the Pacific Ocean and San Francisco Bay are my backyard. Traditional Chinese Medicine discovered me in 1978, when I was struggling with digestive complaints that flummoxed medical doctors. It wasn’t until I received my first acupuncture treatment and herbal prescription that I connected my medical condition to grief over loss of a loved one; that the stress of holding in such huge emotions was literally tying me up in knots, and I was finally able to heal. Discovering the powerful links between the physical, the mental, the emotional, the spiritual, and the environmental shifted my understanding of health and wellness forever. For more than 20 years, I’ve had the privilege of learning and implementing Whole Systems Traditional Chinese Medicine to understand the root causes of health conditions and realize optimal health and well-being. I am a strong believer in the importance of health education, for knowledge is power when you have the tools for effective self care.

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