II. Definitions

  1. Vaginismus
    1. Involuntary contraction of the pelvic floor muscles, inhibiting vaginal entry

III. Pathophysiology

  1. Involuntary muscle spasm of outer third of vagina
    1. Bulbocavernous Muscles
  2. Associated with negative attitudes toward sex
  3. Results
    1. Dyspareunia
    2. Prevents vaginal penetration

IV. Symptoms

  1. Painful Intercourse
  2. Triggered by penis, finger or tampon insertion

V. Associated Conditions

  1. Chronic Pain
  2. Concurrent mood disturbance
    1. Anxiety
    2. Major Depression

VI. Diagnosis

  1. DSM 5 now combines Vaginismus with Dyspareunia
  2. Vaginismus diagnosis (and Dyspareunia diagnosis) per DSM 5
    1. Pelvic Pain, anxiety or vaginal penetration problems for at least 6 months

VII. Evaluation

  1. Rule-out other causes of Vulvodynia

VIII. Management

  1. Biofeedback
  2. Pelvic Floor Exercises
  3. Cognitive Behavioral Therapy Counseling
  4. Avoid perineoplasty (only indicated for Vestibulitis)
  5. Onabotulinumtoxin A (Botox) injections (by Gynecology or Chronic Pain Management)
    1. Bertolasi (2009) Obstet Gynecol 114(5): 1008-16 [PubMed]

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Related Studies

Ontology: Psychologic vaginismus (C0042266)

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
Korean 비기질성 질경련증
Polish Pochwica
Hungarian psychogen vaginismus, Psychogen vaginismus
Norwegian Ikke-organisk vaginisme, Skjedekrampe, Psykogen vaginisme