Vaginismus
In medicine, vaginismus is a condition where the muscles of the vagina contract, preventing sexual intercourse. It can usually be treated effectively by a sex therapist.Vaginismus is a painful or spastic contraction of a woman's pelvic floor muscles that occurs with attempted penetration of the vagina. Young women may be unable to begin having intercourse without pain.
Vaginismus is commonly seen in the gynecological
examining room among young women who appear afraid of
their first pelvic examination. Rather than being uncooperative, such
young women are actually suffering from a reflex they have not yet
learned to control.
Vaginismus is sometimes a secondary
process. A woman who had severe dyspareunia from some physical
cause, such as the structural changes caused by female circumcision,
may develop secondary vaginismus as a reflex. Women who have been
raped, sexually abused, or examined by a rough clinician also may
develop secondary vaginismus.
In general, women who have vaginismus are strongly motivated
to change. Many of them can learn to break their cycle of spastic contractions
even with one limited pelvic exam performed with extreme
gentleness (including a one-fingered vaginal exam and omission of the
rectal exam). Allow the woman to be in charge of the exam; do nothing
without her knowledge and permission, and explain all parts of the
examination in detail in advance. As the exam progresses, reassure the
woman that her pelvic findings are normal (if they are normal). A
partner can be counseled to show the woman the same degree of gentleness
and communication.
Some women may require vaginal dilation as part of the treatment
of vaginismus. The best vaginal dilator is the woman's own finger,
which she can insert with the aid of a little lubricant.
Primary vaginismus
Secondary vaginismus
See also: dyspareunia
