VAGINISMUS

General Information

DEFINITION--Spasms of the muscles around the opening to the vagina; if severe, may prevent intercourse.

BODY PARTS INVOLVED--Muscles surrounding the vagina and muscles of the lower vagina.

SEX OR AGE MOST AFFECTED--Females of all ages.

SIGNS & SYMPTOMS--Involuntary contraction of the muscles around the vagina and rectum. The vagina closes so tightly that the penis cannot penetrate for sexual intercourse. Also prevents the insertion of any object into the vagina, such as a tampon, diaphragm or speculum (used for medical examination).

CAUSES

• An unconscious desire to prevent penile penetration because of emotional or psychological factors. These may include fear, anxiety, hostility, anger or a distaste for sex.
• An insensitive sexual partner, insufficient or unskillful foreplay or inadequate vaginal lubrication prior to attempted penetration.
• Physical disorders (rare), such as infections, allergic reactions or a rigid, non-perforated hymen.
• Vaginal infection.

RISK INCREASES WITH

• First sexual experiences.
• Previous sexual trauma (incest, rape, sexual abuse).
• Stress.

HOW TO PREVENT--Pelvic examination by a doctor and counseling prior to beginning sexual activity.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Diagnostic tests may include pelvic examination to rule out physical disorders (sedation may be necessary for a thorough examination). A sexual history is important and will include early childhood experiences, family attitudes towards sex, previous and current sexual responses, contraceptive practices, reproductive goals, feelings about sexual partner and specifics about the pain you experience.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Treatment will first take care of any medical problems, followed by therapy to eliminate the muscular spasms and psychological problems.
• For muscular spasms, one type of therapy involves dilating the vaginal opening gently and gradually with rubber or glass dilators. Office treatments will probably be necessary 3 times a week and you should practice at home at least twice a day.
• Psychotherapy or counseling is recommended, in addition to, or if dilating treatment is unsuccessful. This may include sensate focus and improving communication with your partner, plus therapy to resolve any conflicts in your life.

POSSIBLE COMPLICATIONS--Psychological trauma caused by guilt, anxiety, loss of self-esteem and feelings of inadequacy, or interpersonal problems resulting from the disorder.

PROBABLE OUTCOME--Curable if the underlying cause can be cured or a coping method can be developed through medical treatment and psychological counseling.

How To Treat

GENERAL MEASURES--

• Prior to dilation or attempted intercourse, sit in a tub of hot water for 10 to 15 minutes. Baths often relax muscles and relieve discomfort. Repeat baths as often as is helpful.
• Before attempting intercourse, you and your partner should use a lubricant, such as K-Y Lubricating Jelly or baby oil.

MEDICATION--Medicine is usually not necessary for vaginismus, but your doctor may prescribe mild sedatives or tranquilizers for short periods of time.

ACTIVITY--No restrictions.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of vaginismus.
• Symptoms don't improve after 3 weeks, despite treatment
• Symptoms recur after treatment.