Vaginismus

The involuntary contraction of muscles which surround the vagina and those of the inner thigh with any kind of attempted vaginal penetration is vaginismus. This makes vaginal tampon / vaginal cup insertion, penile penetration or vaginal speculum gynaecological examination difficult.

Some common questions related to vaginismus is answered here.

• What causes vaginismus?
  The most common reason for vaginismus is the anxiety or fear of vaginal intercourse. It is a phobic response which happens involuntarily. Most of the time, the woman wants to allow penetration. However, the muscle contraction happening involuntarily does not permit it.
  
  A history of abuse may be elicited in some women. It is not always a pre-requisite. Some women may experience severe forms where any kind of penetration is impossible, whereas some women may experience milder forms.
  
  The other causes of vaginal pain syndrome such as vaginal infections, dryness, vulvodynia or endometriosis should be ruled out.
• How common is vaginismus?
  Studies have shown that 1-6% of women are diagnosed with vaginismus. However, it is believed that most cases are unreported as women do not present with this problem.
  
  Painful vaginal intercourse in women is seen in 20% of women.
  
  Some women presenting with infertility, on evaluation, are finally diagnosed with vaginismus. The male partner may present with secondary erectile dysfunction, as a result of anxiety.
• Can vaginismus be cured?
  The short answer is, yes. However, it may take time in some women. Adequate counselling and education of the woman and her partner go a long way in managing this condition. The woman is reassured that the anatomy is normal. Vaginal dilator therapy is proven to benefit. Pelvic floor exercises for relaxation can help train the muscles.
  
  In resistant cases, psychological treatment may be advised. Botox injection into the pelvic floor muscles can relax them and decrease the severity of vaginismus.
• Who is the best doctor for vaginismus treatment?
  Dr Sneha J is a Gynecologist and best fertility and sexual medicine specialist. She has completed MD OBG from the top university AIIMS , Delhi and University fellowship in Fertility/ Reproductive medicine. She had further training in dealing with these conditions at the European Society of Sexual Medicine School, Budapest, Hungary.