陰道痙攣: 可能的病因
在少數罕見的病例，陰道痙攣因為早前的性行為體驗到的疼痛所發展出的保護性反應；這種疼痛由某些外傷或內部性器官的疾病所導致。顯而易見，需要對這種病例所遭受的軀體病因進行治療。
可是，陰道痙攣十分常見的病因完全是心理性的。例如，這個女子從前可能遭受過性創傷體驗(traumatic experience)，譬如被強姦或與一位粗心大意的性伴性交等等。在開始任何的性治療之前，務必要先關注這樣的性創傷體驗。
也可能有較為簡單的病因解釋：自己的性伴不能進行性交或維持勃起的女子可能最終對他性交時徒勞的插入嘗試感到灰心和憂慮，以至於她的陰道不由自主地緊閉起來。另一方面，甚至一位有著正常性反應的男子如果總是遇到這個女子的陰道過緊而不能插入，最終可能也會發生性功能障礙。所以，一對性伴也許會陷入相互失望的惡性循環怪圈。這樣一來，功能障礙是怎樣開始的也就沒有什麼大的差別了。男女雙方也都需要進行治療。
陰道痙攣的另一個可能病因是訓導女孩認為性是骯髒的或邪惡的清規戒律式養育方式。這樣的負面態度根本上可以非常有效地壓抑女孩的性機能。

Vaginismus: Possible Causes
In a few rare cases, vaginismus develops as a protective reaction against previously experienced pain during sexual intercourse which, in turn, was caused by some injury or disease of the internal sex organs. Obviously, in such a case, the underlying physical cause must be treated.
However, very often the causes of vaginismus are entirely psychological. For example, the woman may have had some traumatic experience such as rape or coitus with an inconsiderate partner. Such experiences must be addressed before any treatment can begin.
There may also be a simpler explanation: A woman whose partner is unable to have or hold an erection may eventually become so frustrated and apprehensive about his futile attempts at coitus that her vagina tightens involuntarily. On the other hand, even a man with healthy sexual responses may eventually become dysfunctional if he always finds the woman's vagina too tight for penetration. Thus, a couple may enter a vicious circle of mutual disappointment. It then makes little difference how the problem began. Both the man and the woman need treatment.
Another possible cause of vaginismus is a strict and puritanical upbringing that teaches a girl to consider sex dirty or evil. Such negative attitudes can very well prevent her from functioning sexually at all.