WHO Guide to Mental and Neurological Health in Primary Care
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Vaginismus

Essential information for patient and partner

Vaginismus is an involuntary spasm of the pubococcygeal muscles, accompanied by intense fear of penetration and anticipation of pain. Sexual responses (eg desire, pleasure) may not be impaired unless penetration is attempted or anticipated. It is found more often in younger women than older ones, in women with negative attitudes to sex, and those with a history of previous sexual abuse/assault. Once vaginismus is established, it is usually chronic but it can be overcome with specific psychosexual therapy.

General management and advice to patient and partner

The patient needs to gain confidence and control over vaginal muscle spasm. Exercises (systematic desensitization) involving vaginal muscle relaxation (reverse Kegels) and the systematic introduction of graded trainers (fingers, tampons or vaginal dilators) are successful if coupled with addressing the fear or phobia. Control can then be shared with a partner. Treatment often requires long-term therapy but has a promising outcome. Avoidance of practice and low motivation are common problems.

Last edited: 16/9/2003


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