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Vaginismus and psedovaginizm
Last reviewed: 19.11.2021
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Vaginismus is a reflex contraction of the muscles that compress the vagina when the entrance to the vagina is filled (for example, the penis, finger or other object is inserted), despite the woman's expressed desire to penetrate the subject, in the absence of structural or other physical disorders. Vaginismus is often associated with fear of pain and fear of introducing a foreign body into the vagina.
Vaginismus usually occurs with the onset of sexual activity. The convulsive contraction of the muscles is preceded by the fear of pain during defloration, but in some cases it arises suddenly, unexpectedly for the patient at the time of painful defloration. Soft, tactful husbands do not insist on coitus. When you try again, everything repeats. In the future, vaginismus manifests itself with gynecological examination. Three degrees of vaginismus can be distinguished: 1 degree - the reaction occurs when a penis or instrument is inserted into the vagina during gynecological examination; II degree - the reaction occurs when you touch the genitals or waiting to touch them; III degree - the reaction occurs when one presentation of a sexual act or gynecological examination.
The absence of defloration in marriage is hard experienced by spouses, although in many cases does not worsen interpersonal relationships, and sexual adaptation of the couple occurs at the level of petting or (if possible) vestibular coitus. Women with vaginismus can often experience orgasms, but to contact their doctor makes them feel inferior or have a desire to have a child.
Diagnosis of Vaginismus
For the diagnosis of vaginismus it is necessary to exclude physical causes. For this purpose, the examination is performed after the end of the treatment, which makes the examination possible. The patient is in a sitting position on the chair, after dilution of the labia minora, they are examined in the mirrors or fingered through the hole of the hymen. This simple technique (finger examination) can simultaneously confirm the presence of a normal vagina and presume a diagnosis of vaginismus.
Vaginismus should be differentiated from psedovaginizma, when pain when trying to introject, spasmodic spasm and defensive reaction of a woman are secondary, are caused by damage to the genysegmental component (developmental defects, colpitis, adhesive process and other gynecological diseases that make the introtus sharply painful). In addition, vaginismus must be differentiated from co-tophobia - fear of pain during sexual intercourse, preventing its implementation and not accompanied by convulsive contraction of the muscles of the vagina. Similar phenomena with vaginismus can be caused by incorrect actions, caused by ignorance of the anatomy of the genital organs by both partners. In this case, a single correction is enough to restore the sexual function.
[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13]
Treatment of Vaginismus
The treatment of vaginismus is to change the behavior, including the experience of using a self-contact from the entrance to the vagina and moving slowly forward, thus reducing the fear of subsequent pain. The woman should touch the perineum daily as close to the entrance to the vagina, spreading the small labia with her fingers. When the fear and anxiety from contact with the entrance to the vagina pass, the patient will be able to insert a finger into the hole of the hymen, widening the entrance to the vagina. If the introduction of the finger does not cause any discomfort, vaginal dilators, sized by size, may be recommended. These expanders can be recommended for natural bougie. They allow perivaginal muscles to get used to a gentle increase in pressure without reflex reduction. The first extender a woman can allow to inject a partner during intercourse, it will be less painful, since a woman is sexually excited. If the application of dilators is painless, then the sexual couple should conduct arousal of the vulva by careful introduction of the penis. During sexual play, a woman should get used to feeling a cock on her vulva. Ultimately, a woman can insert a partner in the vagina partially or completely. She can feel more confident while being in the top position. Some men experience situational erectile dysfunction in this position, and phosphodiesterase inhibitors can be recommended.