In medicine, vaginismus is a condition where the muscles at the entrance to vagina contract, preventing successful sexual intercourse. It is most commonly caused by psychological problems but it may sometimes be due to vaginal inflammation.
Psychological causes of vaginismus can usually be treated effectively by a sex therapist.
Vaginismus is a painful or spastic contraction of a woman's pelvic floor muscles that occurs with attempted penetration of the vagina.
Young women may be unable to begin having intercourse without
pain.
Some women with vaginismus shun sexual contact for fear that it may lead to attempted penetration. Other affected women have otherwise normal sexual response, and can reach orgasm through forms of masturbation and outercourse.
Primary vaginismus
Vaginismus is commonly seen in the gynecological
examining room among young women who appear afraid of
their first pelvic examination. Rather than being uncooperative, such
young women are actually suffering from a reflex they have not yet
learned to control.
Secondary vaginismus
Vaginismus is sometimes a secondary
process. A woman who had severe dyspareunia from some physical
cause, such as the structural changes caused by female circumcision,
may develop secondary vaginismus as a reflex. Women who have been
raped, sexually abused, or examined by a rough clinician also may develop secondary vaginismus.
Treatment
In general, women who have vaginismus are strongly motivated
to change. Many of them can learn to break their cycle of spastic contractions
even with one limited pelvic exam performed with extreme
gentleness (including a one-fingered vaginal exam and omission of the
rectal exam). Allow the woman to be in charge of the exam; do nothing
without her knowledge and permission, and explain all parts of the
examination in detail in advance. As the exam progresses, reassure the
woman that her pelvic findings are normal (if they are normal). A
partner can be counseled to show the woman the same degree of gentleness and communication.
Some women may require vaginal dilation as part of the treatment
of vaginismus. The best vaginal dilator is the woman's own finger,
which she can insert with the aid of a little lubricant. Dildoes are also available.
