Vaginismus

(Psychogenic Vaginismus)

Definition

Vaginismus is an uncontrolled, involuntary spasm of the muscles that surround the vagina. These spasms can cause pain when something is about to be put into the vagina, like a tampon, penis, or medical device. This can cause sexual intercourse or a routine pelvic exam to be painful. It is a complex disorder. It is both a psychological and physical condition.Vaginismus is not common. It can cause severe physical and psychological pain.
Vagina
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Causes

Vaginismus is usually a response to past sexual trauma or other painful events. The fear of pain can start a painful muscle spasm. Sex is then associated with fear and pain. Sometimes no obvious cause can be found.There are 2 forms of vaginismus, primary and secondary. Primary vaginismus is diagnosed in women who have never had successful sexual intercourse due to pain or the anticipation of pain. Secondary vaginismus is diagnosed if a woman has had a successful experience without painful intercourse in the past.

Risk Factors

Factors that may increase your chance of vaginismus include:
  • History of sexual abuse or trauma
  • A frightening childhood medical procedure
  • Painful first intercourse
  • Relationship problems
  • Sexual inhibition
  • Fear of pregnancy
  • Memory of previous pain due to infection, surgery, or other gynecologic conditions

Symptoms

Symptoms of vaginismus can range in severity. Women with this disorder are not able to have sexual intercourse without pain. Some women may also have pain during pelvic exams or while inserting a tampon.

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. A vaginal spasm may be detected during the pelvic exam. This can confirm the diagnosis of vaginismus.The insertion of a speculum (device used to gently open the vagina) may be impossible. Vaginal fluid may be minimal. In severe cases, local or general anesthesia may be used to perform an exam.

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