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DESCRIPTION
Vaginismus is the spasms of the muscles around the opening to the vagina; if severe, may prevent intercourse. Vaginismus can affect females of all ages.
FREQUENT SIGNS & SYMPTOMS
Vaginismus is the involuntary contraction of the muscle 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 experience.
Previous sexual trauma (incest, rape, sexual abuse).
Stress.
PREVENTIVE MEASURES
Pelvic examination by a health care provider and counseling prior to beginning sexual activity.
EXPECTED OUTCOME
Curable if the underlying cause can be cured or a coping method can be developed through medical treatment and psychological counseling.
POSSIBLE COMPLICATIONS
Psychological trauma caused by guilt, anxiety, loss of self-esteem and feelings of inadequacy, or interpersonal problems resulting from the disorder.
TREATMENT
GENERAL MEASURES
Diagnostic tests may include pelvic examination to rule out physical disorders (sedation may be necessary for the thorough examination). A sexual history is important and will include early childhood experiences, family attitudes toward sex, previous and current sexual responses, contraceptive practices, reproductive goals, feelings about your sexual partner and specifics about the pain you experience.
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.
Prior to dilation or attempted intercourse, sit in a tub of warm water for 10 to 15 minutes. Baths often relax muscles and relieve discomfort. Repeat baths as often as is helpful.
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.
Before attempting intercourse, you and your partner should use a lubricant, such as K-Y Lubricating Jelly or a natural massage oil (olive, almond, etc.).
MEDICATION
Medication is usually not necessary for vaginismus, but mild sedatives or tranquilizers may be prescribed for short periods of time.
ACTIVITY
No restrictions.
DIET
No special diet.
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NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
You or a family member has symptoms of vaginismus.
Symptoms don't improve after 3 weeks, despite treatment.
Symptoms recur after treatment.
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