Published 18 June 2009, doi:10.1136/bmj.b2284
Cite this as: BMJ 2009;338:b2284

Clinical Review

Diagnosing and managing vaginismus

Tessa Crowley, associate specialist psychosexual medicine1, David Goldmeier, clinical lead Jane Wadsworth sexual function2, Janice Hiller, consultant psychologist3

1 Bristol Sexual Health Service, Bristol BS2 0JD, 2 Imperial NHS Trust, St Mary’s Campus, London W2 1NY, 3 Department of Psychology, Goodmayes Hospital, Ilford, Essex IG3 8XJ

Correspondence to: T Crowley tessa.crowley@bristol.ac.uk

The first 150 words of the full text of this article appear below.


The conditions of vaginismus, vestibulodynia, and dyspareunia overlap
Diagnosis of vaginismus is based on a full psychosexual history
The degree of distress, anxiety, and self reported interference with penetration is more central to the diagnosis than is muscle tone
Genital examination is needed at some point to exclude organic pathology
Information on sexual function and pelvic anatomy should be given to all patients
Treatment comprising insertion of "vaginal trainers" of gradually increasing size is associated with the achievement of penetrative intercourse


Recent consensus defined vaginismus as, "The persistent or recurrent difficulties of the woman to allow vaginal entry of a penis, a finger, and or any object, despite the woman’s expressed wish to do so."1 The definition also noted that affected women often avoid intercourse; experience involuntary pelvic muscle contraction; and anticipate, fear, or experience pain. However, it can be difficult to diagnose vaginismus. Women with total vaginismus are unable . . . [Full text of this article]


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