Two case histories illustrate the occasional effect of homosexual orientation upon the female partner. Couple G was composed of a 26-year-old woman married to a man 37 years old. The wife had been actively homosexual since seduction by an elder sister when she was 12 years old.
There had been no history of heterosexual function before meeting her husband. He was a successful professional man and offered the woman much in the form of social status and financial security. He had been previously married and divorced.
Sexual exposure during the short engagement had been restricted, by female edict, to multiple manipulative approaches. There was total inability to penetrate on the wedding night or to consummate the marriage thereafter. When the unit was seen after 18 months of marriage, the wife's hymen was not intact but there was evidence of severe vaginismus.
Once all of her pertinent history was obtained and shared with her marital partner, there was little further resistance to penile penetration. She was orgasmic with intercourse within two weeks after termination of the acute phase of therapy. Couple H had been married for 7 years. There were two children.
The husband became an alcoholic, lost his job, and left his family without warning. He was out of the home for 3 years before he could be persuaded to seek professional help. There was another year spent in treatment before he could return to family and social position.
Fortunately, there was sufficient financial resource, so no great financial hardship was suffered by his family. The wife, distraught at first, sought support from her best friend, also married and living in the neighborhood.
Within a year an overt homosexual relationship developed. Mrs. H had no prior history of homophile orientation. Two years after her husband left the home, Mrs. H attempted sexual intercourse on several different occasions with two different men, but neither man could penetrate.
There was no further heterosexual exposure after these failures until her husband was released from institutional control to return to normal activity. When attempting intercourse, Mr. H could not penetrate, nor was he able to during the subsequent two years before the couple was seen in therapy.
The vaginismus was obvious at physical examination. The probable cause of her involuntary rejection of coitus was explained and accepted by both partners. Dilators were used effectively and coital functioning was reestablished quickly.
One marriage had existed in a sexual successful state for almost 10 years when the husband was detected in an extramarital affair. There was a 4-month period of continence while marital fences were mended with help from clergy. Although verbally forgiving his transgressions, the wife evidenced vaginal spasm during subsequent attempts at coital connection.
The marital unit's inability to reestablish a successful coital pattern continued for almost 18 months until, consumed with fears for performance, feelings of guilt, and finally of personal rejection, the husband became secondarily impotent. When seen in therapy, both vaginismus and impotence were presenting systems.
There have been 7 more instances of vaginismus treated by Foundation personnel. Onset of symptoms has ranged from evidence of involuntary vaginal spasm with a first coital opportunity to dysfunction secondary to physiological or psychological trauma. There seems little need for further illustration of the onset of the syndrome.
Regardless of onset, an effective therapeutic approach is to establish the etiological influences by careful history-taking, and then to approach treatment confidently. With adequate dissemination of information so that full appreciation of onset of the sexual dysfunction is acquired by couple involved, and the sexual partners' mutual cooperation in therapy, reversal of the syndrome of vaginismus is accomplished with relative ease.