Vaginismus
Definition[edit | edit source]
Vaginismus is a penetration disorder in which any form of vaginal penetration is painful or impossible. It has traditionally been referred to as an involuntary contraction of the pelvic floor muscles due to actual or anticipated pain associated with vaginal penetration. It causes women to feel pain, fear and anxiety with penetration attempts.[1]It is often associated with psychological problems, leading to poor sexual quality of life (SQOL).[2]
The debate around its definition[edit | edit source]
Prevalence and Incidence[edit | edit source]
It affects about 1-7% of the female population worldwide.[1]
Etiology[edit | edit source]
The etiological factors are
ORGANIC PATHOLOGIES[edit | edit source]
- Congenital abnormalities
- Local infections
- Trauma associated with childbirth
- Genital surgery or radiotherapy
- Vaginal lesions and tumors [4][3]
PSYCHOLOGICAL FACTORS[edit | edit source]
- Sexual abuse
- A negative attitude toward sexuality
- Relationship difficulties
- Fear of first-time sex (pain, bleeding, tearing, ripping, penis too large, vagina too small, sexually transmitted diseases, fear of pregnancy)[5]
- Fear of gynecological examinations[5]
- A maternal influence involving grandmothers, mothers, twins, and sisters-The influence is due to merely hearing about the difficulties faced by them and the patient may manifest it as a subsequent fear of penetration.
Quality of life[edit | edit source]
This condition influences the quality of life, in the most serious form it can result in an unconsummated marriage, sterility and thus further results to couple leading a separate life . [1]It is correlated with poor sexual quality of life[2] and even the male partners may have important effects on the development, maintenance, and exacerbation of vaginismus ( in lifelong vaginismus -LLV).[6]
Symptoms[edit | edit source]
These symptoms are defined accordingly given by Diagnostic and Statistical Manual of Mental Disorders (DSM, the American Psychiatric Association), fifth edition(DSM-5)[7]-
- Difficulty having intercourse
- Genito-pelvic pain
- Fear of pain or vaginal penetration
- Tension of the pelvic floor muscles.
Classification[edit | edit source]
| GRADES | DESCRIPTION |
|---|---|
| Lamont grade 1 | Patient is able to relax for pelvic examination |
| Lamont grade 2 | Patient is unable to relax for pelvic examination |
| Lamont grade 3 | Buttocks lift off table. Early retreat |
| Lamont grade 4 | Generalized retreat: buttocks lift up, thighs close, patient retreats |
| Pacik grade 5 | Generalized retreat as in level 4 plus visceral reaction, which may result in any one or more of the following: palpitations, hyperventilation, sweating, severe trembling, uncontrollable shaking, screaming, hysteria, wanting to jump off the table, a feeling of becoming unconscious, nausea, vomiting, and even a desire to attack the doctor |
Assessment[edit | edit source]
Management[edit | edit source]
- Behavioral sex therapy
- CBT
- Pharmacological therapy,
- Pelvic floor physiotherapy
- Removal of hymenal remnants
References[edit | edit source]
- ↑ 1.0 1.1 1.2 Laskowska A, Gronowski P. Vaginismus: An overview. The Journal of Sexual Medicine. 2022 May 1;19(5):S228-9.
- ↑ 2.0 2.1 Psychological predictors of sexual quality of life among women with vaginismus, Velayati A, Jahanian Sadatmahalleh S, Ziaei S, Kazemnejad A. Psychological predictors of sexual quality of life among Iranian women with vaginismus: A cross-sectional study. International Journal of Sexual Health. 2022 Jan 2;34(1):81-9.
- ↑ 3.0 3.1 Maseroli E, Scavello I, Rastrelli G, Limoncin E, Cipriani S, Corona G, Fambrini M, Magini A, Jannini EA, Maggi M, Vignozzi L. Outcome of medical and psychosexual interventions for vaginismus: a systematic review and meta-analysis. The journal of sexual medicine. 2018 Dec 1;15(12):1752-64.
- ↑ Lahaie MA, Boyer SC, Amsel R, Khalifé S, Binik YM. Vaginismus: a review of the literature on the classification/diagnosis, etiology and treatment. Women’s Health. 2010 Sep;6(5):705-19.
- ↑ 5.0 5.1 Pacik PT. Understanding and treating vaginismus: a multimodal approach. International urogynecology journal. 2014 Dec;25(12):1613-20.
- ↑ Turan Ş, Sağlam NG, Bakay H, Gökler ME. Levels of depression and anxiety, sexual functions, and affective temperaments in women with lifelong vaginismus and their male partners. The Journal of Sexual Medicine. 2020 Dec 1;17(12):2434-45.
- ↑ American Psychiatric Association DS, American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. Washington, DC: American psychiatric association; 2013 May.
