Vaginismus

Involuntary painful contraction (spasm) of the lower vaginal muscles.

Vaginismus may relate to dyspareunia. It may be triggered by fear of losing control or of being hurt during intercourse, by a vaginal infection, or by vaginal mucosal irritation. Observation of an involuntary vaginal spasm during pelvic examination confirms the diagnosis, but a pelvic examination may not even be possible in the presence of severe vaginismus.

Painful physical disorders should be corrected. Emotional relaxation techniques and pelvic muscular exercises (eg, voluntary contraction and relaxation of the pubococcygeal and muscles of the introitus) can help reduce muscular spasm. Gradual dilation of the vagina should be performed by the patient, partner, physician, or sex therapist using fingers or a dilator. Intercourse can be attempted after the patient has tolerated insertion of at least 3 fingers or a large dilator without discomfort.