Sixty-two women participated in a study designed to explore the association between genital and subjective sexual arousal. Four stimulus conditions were created, designed to evoke differential patterns of genital arousal over time. Subjects were instructed to report sensations in their genitalia while being exposed to the same erotic stimulus on repeated trials or to a series of varying erotic stimuli. Detection of genital arousal was facilitated by the occurrence of changes in genital arousal over trials. That is, genital and subjective sexual arousal were linearly related in conditions that resulted in large differences in genital arousal over trials, whereas such a relation was absent in conditions in which genital arousal levels remained relatively constant. In women, peripheral feedback from consciously detected genital arousal seems to be a relatively unimportant determinant of subjective sexual arousal.

This study investigates the mechanism underlying vaginismus, which may be part of a general defense mechanism. Exposure to a threatening situation will evoke an increase in muscle activity. This muscle reaction will not be restricted to the pelvic floor but will also occur in postural muscles, such as in the trapezius region. Women with and without vaginismus were exposed to four stimuli: excerpts from threatening, erotic, neutral and sexual-threatening films. Subjects were 45 physician- or self-referred patients with vaginismus and 32 controls with no sexual or pelvic floor complaints. The activity of the pelvic floor muscles and of the muscles in the trapezius region was recorded with surface electrodes. There were no differences between women with and without vaginistic reactions. EMG measurement of both the pelvic floor muscles and the trapezius muscle showed an increase in muscle activity during the threatening and sexual-threatening excerpts in women with and without vaginismus. This increase of involuntary pelvic floor muscle activity is part of a general defense mechanism that occurs during exposure to threatening situations. This reaction is not restricted to a situation with a sexual content. The results of this study shed new light on the concept of vaginismus as a primarily sexual dysfunction.

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