Vaginismus is an involuntary contraction of muscles around the opening of vagina in women causing muscle spasms 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.