II. Definitions
- Vaginismus
- Involuntary contraction of the pelvic floor muscles, inhibiting vaginal entry
- Genito-Pelvic Pain Penetration Disorder
- Term that combines Dyspareunia with Vaginismus
III. Pathophysiology
- Involuntary muscle spasm of outer third of vagina
- Bulbocavernous Muscles
- Associated with negative attitudes toward sex
- Fear or anxiety about vaginal penetration
- May be triggered by prior sexual Trauma or medical conditions
- However, not all women with Vaginismus have predisposing factors
- Results
- Dyspareunia
- Prevents vaginal penetration
IV. Symptoms
- Painful Intercourse
- Triggered by penis, finger or tampon insertion
V. Associated Conditions
- Chronic Pain
- Concurrent mood disturbance
- Anxiety
- Major Depression
VI. Diagnosis
- DSM 5 now combines Vaginismus with Dyspareunia (Genito-Pelvic Pain Penetration Disorder)
- Vaginismus diagnosis (and Dyspareunia diagnosis) per DSM 5
- Pelvic Pain, anxiety or vaginal penetration problems for at least 6 months
- Primary Vaginismus is diagnosed in those who have never had painless vaginal penetration
- Secondary Vaginismus is diagnosed with prior painless vaginal penetration
VII. Differential Diagnosis
- See Dyspareunia
- Differentiate from entry Dyspareunia causes
- Vaginal infection or Vaginitis
- Vulvodynia
- Pelvic Floor Dysfunction
VIII. Evaluation
- Rule-out other causes of Vulvodynia
IX. Management
- Biofeedback
- Pelvic Floor Exercises
- Cognitive Behavioral Therapy Counseling
- Relationship and sexual counseling
- Vaginal Lubricants
- Sequential Vaginal dilation
- Avoid perineoplasty (only indicated for Vestibulitis)
- Onabotulinumtoxin A (Botox) injections (by Gynecology or Chronic Pain Management)
Images: Related links to external sites (from Bing)
Related Studies
| Definition (MSH) | Recurrent or persistent involuntary SPASM of the outer muscles of the VAGINA, occurring during vaginal penetration. |
| Concepts | Mental or Behavioral Dysfunction (T048) |
| MSH | D052065 |
| ICD9 | 306.51 |
| ICD10 | F52.5 |
| SnomedCT | 268773000, 192469003, 154924008, 71787009 |
| DSM4 | 306.51 |
| English | Psychogenic vaginismus, Vaginismus (Not Due to a General Medical Condition), Psychologic vaginismus, Non-organic vaginismus, Nonorganic vaginismus, vaginismus not due to physical condition (diagnosis), vaginismus not due to physical condition, Vaginismus psychogenic, Vaginismus [Disease/Finding], Vaginismus;psychogenic, vaginismus, Non-organic vaginismus (disorder), Psychologic vaginismus (disorder), nonorganic origin; vaginismus, vaginismus; nonorganic, Psychogenic Vaginismus, Functional vaginismus, Vaginismus, psychogenic vaginismus |
| Dutch | psychogeen vaginisme, vaginisme psychogeen, niet-organische oorsprong; vaginisme, vaginisme; niet-organisch, Niet-organisch vaginisme |
| French | Vaginisme psychogène, Vaginisme |
| German | Vaginismus psychogen, psychogener Vaginismus, Scheidenkrampf, Nichtorganischer Vaginismus, Vaginismus |
| Italian | Vaginismo psicogeno, Vaginismo |
| Portuguese | Vaginismo psicogénico, Vaginismo |
| Spanish | Vaginismo psicógeno, vaginismo psicológico (trastorno), vaginismo psicológico, Vaginismo |
| Japanese | 心因性腟痙, ｼﾝｲﾝｾｲﾁﾂｹｲ |
| Swedish | Vaginism |
| Czech | vaginismus, Psychogenní vaginismus, vaginizmus |
| Finnish | Vaginismi |
| Russian | VAGINIZM, ВАГИНИЗМ |
| Korean | 비기질성 질경련증 |
| Polish | Pochwica |
| Hungarian | psychogen vaginismus, Psychogen vaginismus |
| Norwegian | Ikke-organisk vaginisme, Skjedekrampe, Psykogen vaginisme |
