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Vaginismus and Non-Consummation
Published in Philipa A Brough, Margaret Denman, Introduction to Psychosexual Medicine, 2019
Vaginismus can be a primary or a secondary symptom. It is useful not to think of vaginismus as a disorder in itself but a symptom that expresses psychological distress that may or may not be physical in origin. Involuntary pelvic floor spasm is the usual underlying disorder that is a protection from pain – pain being of the mind and/or body. Rationalising the physiological response may not enable the woman to control this. Understanding and interpreting the defences involved in this response is the aim of psychosexual treatment, using both the feelings of the woman and the doctor, during their interaction. Access to the denied or suppressed feelings of the patient by both the patient and doctor can enable access to the vagina (Figure 13.1).
Miscellaneous conditions affecting the genitalia
Published in Shiv Shanker Pareek, The Pictorial Atlas of Common Genito-Urinary Medicine, 2018
Vaginismus is an involuntary tightening of the vagina during attempted intercourse, which makes it difficult to perform normal penetration. It is caused by spasm of the pelvic muscles and contraction of the muscles around the lower part of the vagina. The tightening of the muscles may be so extreme that the vagina closes completely and penetration is impossible. The cause of the condition may be psychological (due to abuse, or to an early bad experience with attempted sex or vaginal examination) or the result of an infection or injury to the vagina or bladder.
Conditions
Published in Sarah Bekaert, Women's Health, 2018
Vaginismus occurs when the muscles around the vagina tighten involuntarily, causing the vagina to spasm and possibly causing pain. It is a psychological problem that is manifested in a physical way, and is fairly common. The vaginal muscles go into spasm, usually in response to the vagina or vulva being touched before sexual intercourse. It can also occur if penetration of the vagina by the penis is attempted, or during a gynaecological examination. Vaginismus can cause emotional distress and relationship problems. Women who have vaginismus are able to achieve orgasm during mutual masturbation, foreplay and oral sex. It is only when sexual intercourse is suggested or attempted that the vagina tightens to prevent penetration.
Tending to painful sex: applying the neuroscience of trauma and anxiety using mindfulness and somatic embodiment in working with genito-pelvic pain and penetration disorders
Published in Sexual and Relationship Therapy, 2023
With 50% of women experiencing trauma in their lifetime, the most frequently experienced physical traumas faced by women are childhood sexual abuse and sexual assault (Kessler et al., 2005). More specifically, research suggests that emotional and psychosocial childhood trauma reveal strong correlation among women living with vaginismus, dyspareunia and vulvodynia (now in the cluster called GPP/PD). Additionally, growing up in authoritarian households, with a lack of access to sex education, negative ideas about sex and/or stronger religious influences (Fadul et al., 2019) has been suggested as a contributor to ongoing sexual problems in women. Between 12% to 21% of women experience vaginismus in their lifetime (Landry & Bergeron, 2009). Further data suggests GPP/PD more broadly correlating with emotional neglect and early childhood trauma (Özen et al., 2018) and anxiety (Khandker et al., 2011 in Basson & Gilks, 2018). Additionally, research confirms that individuals from the LBTQ communities face additional exposure to all varieties of physical, sexual and emotional trauma for their sexual and gender expression (Scheer et al., 2020).
Psychological Predictors of Sexual Quality of Life Among Iranian Women With Vaginismus: A Cross-Sectional Study
Published in International Journal of Sexual Health, 2022
Atefeh Velayati, Shahideh Jahanian Sadatmahalleh, Saeideh Ziaei, Anoshirvan Kazemnejad
Vaginismus is a sexual disorder that can adversely affect marital relationships and quality of lives (Molaeinezhad et al., 2014). It was classified as a genito-pelvic pain/penetration disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). There is a great overlap between vaginismus and other sexual disorders such as vulvodynia and dyspareunia making them difficult to distinguish (Dick et al., 2021). Vulvodynia, particularly as a chronic pain condition of unknown causation, is affecting between 7% and 15% of women, is a frequently missed pathology and often confused with vaginismus (Barnabei, 2020). As a result, in the most cases, it is more likely not to be diagnosed properly (Vieira-Baptista et al., 2017). Vaginismus is diagnosed based on a woman’s history of involuntary, persistent or recurrent pelvic floor muscle spasms while inserting any external object such as finger, tampon, penis and gynecologic examination (Aslan et al., 2020). Of course, this condition may depend on the situation and some women would experience this more with penile penetration, but not gynecological exams or tampon insertion (Goldfarb et al., 2013).
The Role of Anxiety and Childhood Trauma on Vaginismus and Its Comorbidity with Other Female Sexual Dysfunctions
Published in International Journal of Sexual Health, 2020
Sinan Tetik, Eylem Unlubilgin, Fulya Kayikcioglu, Nurhan Bolat Meric, Nurettin Boran, Ozlem Moraloglu Tekin
The sample of the study consisted of 50 patients diagnosed with primary vaginismus who applied to the sexual dysfunction outpatient clinic of a gynecology training and research hospital in Ankara, the capital city of Turkey, and 50 subjects for comparison who were admitted to the same hospital between October 2018 and May 2019. The patient group who participated in the study was examined by a female gynecologist in the sexual dysfunction outpatient clinic. Pelvic examination of the patient group included assessment of the external appearance of the vulva, vulvar sensitivity (using a cotton swab to exert light pressure on the vulva and labium), and anatomy of the hymenal ring. The majority of the patient group had difficulty having the gynecological examination. Only three out of 50 patients could have a pelvic examination in the first session. The presence of an involuntary contraction of some or all of the pelvic floor muscles was noted by the gynecologist. Rejection of pelvic examination or distress displayed by the patient during the pelvic examination were also noted. Patients who had no gynecological complaint were referred to the psychologist. After the clinical interview with the psychologist, volunteers among the participants who were diagnosed with primary vaginismus according to the DSM-4-TR diagnostic criteria were included in the study. In the sexual history taken from all the patients, no sexual problems that meet the diagnosis of another primary and independent sexual dysfunction were detected.