Sexual Health and Wellness

DYSFUNCTIONS: VAGINISMUS

Features

  • Vaginismus refers to persistent or recurrent involuntary spasm of the musculature of the outer third of the vagina that interferes with sexual intercourse.
  • Sexual responses (e.g., desire, pleasure, orgasmic capacity) may not be impaired unless penetration is attempted or anticipated. The physical obstruction due to the muscle contraction usually prevents penetration.
  • In some cases, the intensity of the contraction may be severe or prolonged as to cause immense pain.
  • Vaginismus may be accompanied by interpersonal difficulty (e.g., relational dissatisfaction) and reports of avoiding sexual activity and limiting the development of new sexual relationships.
  • The diagnosis is often made during routine gynecological examinations when response to the pelvic examination results in the contraction of the vaginal outlet. Sometimes the contraction may occur during sexual activity but not during the examination.
  •  Vaginismus can be primary, in which the person has always experienced the contraction during sexual activity.
  • Vaginismus can be secondary, in which the person used to experience penetration, but no longer can.
  • Vaginismus can be focused, in that the contraction relates to a specific partner or context.
  • Vaginismus may be general, in that the person experiences contractions irrespective of the sexual stimuli.

Epidemiology This condition is more often found in younger than in older females, in females with negative attitudes toward sex, and in females who have a history of being sexually abused or traumatized. Causes Many things can cause vaginismus; it can be a psychological problem, or a combination of a physical and psychological problem. Treatment Every woman will have a unique set of circumstances causing her involuntary spasm, and likewise the treatment plan should be individually tailored to meet her special needs. A detailed medical, sexual and social history should be obtained and certain blood tests carried out. This may uncover any underlying medical or psychological condition. Based on the information uncovered the treatment plan will target at the factors that may be lowering sexual interest. When an underlying medical condition is found, this will be treated first.