About Vaginismus
Vaginismus is definited as the psychologically mediated involuntary spasm of the vaginal muscles including the levator ani muscle and or the thigh adductor muscles.
This results in inability of penetrative sexual intercourse.
Aetiology
Primary
Nothing has entered into the woman's vagina ever. However the vagina is normal anatomically and physiologically . The cause is mostly psychosexual in origin.
There is often presence of a subconscious fear of sexual intercourse (sexual phobias).
Secondary
Vaginismus usually appear after childbirth or any other event in life.
There is usually some local painful lesion. Such lesions include vulvitis, laceration of the hymen, tender scar on the perineum or narrow vaginal introitus. The entity is usually transient and is relieved, when the cause is removed.
Clinical presentation
The woman with Vaginismus avoid vaginal examination and smear. She might present with painful sexual intercourse or with infertility.
Diagnosis
While diagnosis of the secondary one is not so difficult but to find out the cause of the primary one, examination under anaesthesia may be required. If the two fingers can be easily introduced through the vaginal introitus, the calibre of the vagina is proved normal.
Treatment
Psychodynamic therapy
Main cause of fear are removed. To educate and to gain confidence of the husband and wife. This may take time.
Behaviour therapy
Dilatation of the vaginal introitus digitally followed by introduction of gradually increasing size of the dilators is to be done.
Plastic vaginal trainers with graduated size can help her to remove her fear.
This will gain her confidence that her vagina is anatomically of normal calibre.
Vaginal dilators
Daily introduction of the dilators for 1-2 weeks and to keep it inside for 10-15 minutes is enough before she is allowed to attempt coital act.
Surgery
A classic case of Vaginismus needs no surgery. However surgery may be required if the hymen found tight-hymenectomy or Fenton's operation if the introitus is narrow.
The selection of homoeopathic remedies based on symptom similarities and doses according to the Susceptibility of patient.
Don't take homoeopathic medicine without any prescription / without any advise of physician.
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