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Vaginismus is defined as a recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that interferes with any kind of penetration. Penetration causes marked distress or interpersonal difficulty. Vaginismus is not accounted for by another Axis 1 disorder nor is it due exclusively to the direct physiological effects of a general medical condition.
The pathophysiology of vaginismus stems from a cycle of anticipatory pain, involuntary tightening of vaginal muscles (a reflex response), avoidance and mistrust, leading to more anxiety and fear generated by a continuing anticipation of pain in subsequent attempts at penetration.
Any condition which can induce a sensation of pain in the vagina can provoke a reflex spasm. Fears, lack of lubrication, reduced stretching ability, and inflammation describe the general features exhibited for vaginismus.
Familiarity with one’s own sexuality, relaxation techniques ,medications such as propranolol or alprazolam , gaining control over the muscles surrounding the interoitus and gradual dilators (cone shape or rounded rod-shaped appliances ) have been the mainstay of vaginismus treatment thus far.