A Family Doctor's Tale -VAGINISMUS

DOC I HAVE VAGINISMUS

Vaginismus is the tightening of the muscles surrounding the vaginal opening and lower vagina to prevent penetration.

The adductor muscles of  the thighs may also be involved(squeezing of the thighs to prevent penetration)

Vaginismus is usually caused by the following:

Psychological:
1.fear of pain during sex.

2.Inadequate or faulty sex education

Physical:
1.Previous sexual assault or rape

2.Clumsy inept sexual technique by male partner

3.Scarring or injury to vulva area previously

4.Bartholin cyst infection or other infection around the vulva

5.menopause with dryness of the vagina

6.vagina tumors, cancers, inflammations

7.Pelvic trauma or surgery in the past


Persons who has Acute vaginismus has the following
Symptoms:

1.Penetration impossible or partial


2.Ignorance of sexual anatomy,physiology or sex technique


3.Abnormal sexual or psychological history

Signs:
1.Vaginal examination using a single finger causes intense spasm

2.Vulva may show previous injuries, bartholin cyst infection or other infection

Diagnosis can usually be made by :
1.History of unfulfilled vaginal penetration due to spasm

2.psychological fear of sexual intercourse

Treatment:
1.Counseling and psychological education of both partners

2.sex education of the anatomy of the female vagina and male penis , also the anatomy of pelvic pain and muscle spasms

3.progressive insertion of fingers

4.insertion of well lubricator dilators useful

4.dilation under anesthesia helpful

5.plastic surgery to enlarge opening

6.treat any physical cause of vaginismus

7.pelvic muscle exercises and relaxation methods

8.co-operation between the sexual partners


Prognosis is usually good with counseling.


Sexual partner may need to be educated.


Better if patient accepts the sex education