VAGINISMUS

Vaginismus is defined as the psychogenically mediated involuntary spasm of the vaginal muscles including the levator ani muscles and/or the thigh adductor muscles. This results in inability of penetrative sexual intercourse.

ETIOLOGY: -

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 lesions. Such lesions include vulvitis, lacerations 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 avoids 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 anesthesia may be required. If the two fingers can be easily introduced through the vaginal introitus, the caliber of the vagina is proved normal.

TREATMENT

PRIMARY: The following guidelines are prescribed:

PSYCHODYNAMIC THERAPY: Main causes of fear are removed. To educate and to gain confidence of the husband and wife. This may take time.

BEHAVIORAL THERAPY: Dilatation of the vaginal introitus digitally followed by introduction of gradually increasing size of the dilators is to be done. Plastic vaginal trainers (Pseudopenises) with graduated sizes can help her to remove her fear.

This will gain her confidence that her vagina is anatomically of normal caliber.

VAGINAL DILATORS: Daily introduction of the dilators (pseudopenises) for 1–2 weeks and to keep it inside for 10–15 minutes is enough before she is allowed to attempt coital act.

SECONDARY: The local lesion is to be treated medically.

HOMOEOPATHIC MANAGEMENT OF VAGINISMUS: -

Homoeopathy carries a great scope to treat a number of Gynecological complaints including Vaginismus. These medicines work to relax the muscles of vagina very efficiently and bring on gradual recovery.

PLATINA: - Females having complaints of difficult intercourse from muscle spasm of vagina. They can also have vaginal muscle spasm during Gynecological examination. There is extreme sensitiveness and tenderness of genitals.

SEPIA: - For painful intercourse. Tenderness of sexual parts to touch. Vaginal dryness may be marked in them. Burning sensation in the vagina and vulva present. They also have low sex drive. One of the best medicine for many complaints in females arising during menopause.

NATRUM MUR: - Females requiring it feel a burning and smarting sensation in vagina during coition. With this they have low sexual desire.

IGNATIA: - Its use is considered in cases having spasm of muscle of vagina along with sore pain at the entry of vagina during intercourse. In many cases requiring it the vagina and vulva can be inflamed too.

CANTHARIS: - For cases where Involuntary vaginal muscle spasm and irritation at the vulva are present. Swelling can also be there at vulva. Additionally, the genitals are over sensitive. There can be presence of urinary tract infections in many cases requiring it.