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, irritations from douches, spermicides or latex in condoms and pelvic infections.

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.

Patients who do not respond to this therapy should be referred to a sex therapist. Experienced therapist can address the underlying issues during sex therapy sessions and sometime it can resole the problem completely. The results are very good for the sex therapy combined with medical and relaxations techniques.


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