Patients' perceptions

doi:10.1136/bmj.b3267

Published 11 August 2009, doi:10.1136/bmj.b3267
Cite this as: BMJ 2009;339:b3267

Letters

Vaginismus

Patients’ perceptions

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

The clinical review on vaginismus does not discuss patients’perceptions of what is inside them.¹ Despite widespread sexualeducation, a fact remains: men can see and handle their genitals,whereas women have to find out what they have, which can befraught with guilt, misinformation, and fear, leading to fantasy.

Menstrual bleeding, expected or unexpected, is not a pleasantintroduction to sexual life, and early attempts with tamponscan lead to believing that the vagina is a narrow tube and thatentry is painful.

Just a few examples of patients’ fears: they are verysmall "down there"; the doctor is dealing with a "dirty" partof the body; the hymen is a complete tight membrane with smallperforations; the urethra and vagina are not separate; the liningof the vagina is "like tissue paper and will tear"; internaldamage from childhood sexual abuse, a long kept secret, willbe revealed.

. . . [Full text of this article]

Ann G Parker, retired doctor and former member, Institute of Psychosexual Medicine¹

¹ Ross on Wye, Herefordshire HR9 5BH

dkparker@waitrose.com