Vaginismus

  • February 6, 2019

Vaginismus  is an involuntary contraction of muscles around the opening of vagina in women causing muscle spasm with no abnormalities in the genital organs.

TYPES:

  1. Primary Vaginismus -Pain with or an inability to tolerate insertion upon first attempts(usually a tampon or finger around puberty).
  2. Secondary Vaginismus -Pain or Spasm that is developed in later stages of life.It can also result fom menopause or gynecological cancers.

CAUSES:

  • Anxiety and fear of having sex
  • Traumatic life events like rape
  • A belief that sex is wrong
  • Relation problems
  • Infections
  • Painful medical conditions like Pelvic Surgery

SYMPTOMS:

  • Dysparenia (pain during intercourse)
  • Pain during tampon insertion
  • Pain with bowel movements
  • Pain during gynecological examination
  • Muscle Spasm

DIAGNOSIS:

  • Based on Symptoms and Examination

TREATMENT:

  • Medical
  • Education and Counseling
  • Physiotherapy
  • Behavior therapy
  • Surgery

Medical treatment -Drugs like Vaginal diazepam.

PHYSIOTHERAPY TREATMENT

Goals of treatment

  • To reduce involuntary tightening of pelvic floor muscles mainly pubococcygeus.
  • To reduce fear of pain.

Exercise Protocol followed at Progressive Care :

In this condition there is usually significant pelvic floor dysfunction that needs to be      addressed first.

  • Relaxation techniques – Breathing Exercises and gentle touching exercises.
  • For Chronic pain – Internal Pelvic floor Myofascial treatment.

A Randomized Clinical Trial was presented at International Pelvic Pain Society Conference and has been published in the Journal of Urology (2012) which demonstrated that this exercise was effective in 59% of patients compared to generalized massage therapy.

  • Vaginal dilators.
  • Pelvic floor strength training
  • Pain education
  • Biofeedback – To learn how to relax muscles , to minimize pain,to reduce anxiety.

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