- occlusion of the vaginal opening caused by spasm of the surrounding muscles
- penile entry is impossible or painful
Biology- •when sexually aroused the upper 2/3 of the vagina are lax and capacious, whereas the lower 1/3 is closely invested by the surrounding musculature of the pelvic floor – the strongest is the levator ani
- if these muscles are too tense then penile entry is occluded
- pain or anticipation of pain can cause further muscle contraction
Epidemiology
- prevalence is around 10%
Aetiology
- the majority are primary
- onset can sometimes be related to a traumatic episode (painful examination, rape)
- sometimes vaginismus results from ambivalence about the relationship, or it may be due to reluctance to assume the mature adult’s role
Management
- exploration of own genitalia – finger insertion, combined with sensate focus techniques
- additional dilatation may be required using graded dilators
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