Vaginismus

Vaginismus is a perplexing and fascinating problem. The woman who experiences the involuntary, spasmodic contraction of the pubococcygeus and related muscles controlling the vaginal introitus may be unable to tolerate penetration or have intercourse but may be quite capable of becoming sexually aroused, lubricating, and even experiencing multiple orgasms with manual or oral stimulation (Leiblum 2000). Some "virgin" wives and their partners report a rich sexual repertoire. However, when a vaginismic woman senses or fears that her vagina is going to be "penetrated," her circumvaginal muscles contract, her anxiety increases, and intercourse becomes impossible. It is not uncommon for women to have experienced years of dating and/or marriage without being able to accomplish the vaginal penetration of a gynecologist's speculum, an erect penis, or even their own fingers. In fact, many vaginismic women are unable to use tampons and have avoided gynecological examinations. Consequently, vaginismus not only causes considerable personal and relationship frustration but also thwarts adequate gynecological health care (e.g., Pap smears) and procreation. Often, it is threat of divorce or the desire to have children that ultimately propels a woman to seek treatment.

Prevalence

Although estimates of the incidence of vaginismus vary widely, it is likely that it occurs with greater frequency than is typically acknowledged. Vaginismus rates of between 12% and 17% have been reported in women presenting to sex therapy clinics (Spector and Carey 1990). The most recent National Health and Sexual Life Survey, which used random sampling and structured interviewing, reported that between 10% and 15% of women reported having experienced pain during intercourse during the last 6 months (Laumann et al. 1994). However, this study did not differentiate between vaginismus and dyspareunia.