Involuntary painful contraction of perineal muscles and levator ani prior to or during vaginal intercourse. The experience of or even the anticipation of pain on vaginal entry causes these muscles to contract, occluding the vaginal opening and causing further pain when penetration is attempted. Repeated dyspareunia (pain with intercourse) can cause vaginismus and vaginismus can cause dyspareunia.
[...] RISK FACTORS Previous sexual trauma, but rates appear to be similar in abused and nonabused women Often associated with other sexual dysfunctions ETIOLOGY Primary: Often multifactorial - Negative messages about sex and sexual relations in upbringing may cause phobic reaction - Poor body image of genital area - History of sexual trauma, although rates of vaginismus appear to be similar in sexually abused and nonabused populations of women (studies show incidence of sexual abuse of women to be 12-40%) Secondary - New onset of infection - Surgical or postdelivery scarring - Endometriosis - Inadequate vaginal lubrication Can be complete (perineal spasm with attempts to insert anything into vagina) or situational (tampons or pelvic exams permitted) ASSOCIATED CONDITIONS Marital stress, family dysfunction Dyspareunia DIAGNOSIS SIGNS AND SYMPTOMS Inability to allow entry for vaginal sexual intercourse secondary to involuntary muscle spasms Reluctance or avoidance of pelvic examination Relationship discord or difficulty Infertility Sexual satisfaction may be independent of sexual function. [...]
[...] History of sexual abuse does not predict outcome negatively or positively. Bibliography Obstetrics and Gynecology An Illustrated Colour Text. The 5-Minute Consult Clinical Companion to Women's Health. J.S.Berek - Novak's Gynecology. 13th edition. Current Obstetrics Gynecology 9th.Ed. Kimono VAGINISMUS DESCRIPTION Involuntary painful contraction of perineal muscles and levator ani prior to or during vaginal intercourse. The experience of or even the anticipation of pain on vaginal entry causes these muscles to contract, occluding the vaginal opening and causing further pain when penetration is attempted. [...]
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