Vaginismus
An involuntary or persistent spasm of the muscles of
the outer third of the vagina, not attributable to physiological effects of
physical causes. Vaginismus may be either lifelong or recent; generalized to
all sexual encounters or specific to certain partners or situations. There
is a relationship of this disorder with victims of rape and sexual abuse,
strict religious upbringings, and issues of control
Vaginismus can have medical causes, including:
scars in the
vagina from an injury, childbirth or surgery
Vaginismus also can have psychological causes.
it can be a response to a fear, such as fear of losing control or fear of
pregnancy. it can also stem from pain or trauma such as rape or sexual
abuse.
Treatment involves
addressing underlying issues, medical treatment for possible correctible
causes, gradual vaginal dilation and sex therapy. Some cases of generalized
vaginismus treatment may involve teaching the woman to insert her own
fingers into her vagina, and after practice, when the woman is comfortable
she may use the hand- over technique to introduce her partner's fingers into
her vagina, whilst relaxing. Ultimately progression to penile insertion is
encouraged.
Progressive muscle relaxation can be taught during an instructional examination by having the patient alternate contracting and relaxing the pelvic muscles around the examiner's finger. Women with vaginismus can achieve vaginal dilatation with the use of commercial dilators or tampons of increasing diameter, placed into the vagina for 15 minutes twice daily. Once the patient can easily accept an equivalent-sized dilator into the vagina, penile penetration by the partner can occur. Success rates approach 90 percent.