Materiały źródłowe

• #1 Vaginismus: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.vaginismus-care-instructions.uf8637

  Vaginismus is a spasm of the muscles around the opening to the vagina. This spasm can make sex painful and even impossible. […] Treatment may include counseling. And you may get training on how to relax or stretch out your muscles. These treatments can help reduce pain during sex. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Follow any directions your doctor gives you on how to widen, or dilate, your vaginal opening. […] Call your doctor now or seek immediate medical care if: You have new or worse belly or pelvic pain. You have severe vaginal bleeding. […] Watch closely for changes in your health, and be sure to contact your doctor if: You have unusual vaginal bleeding. You do not get better as expected.

• #2 Vaginismus – Florida Center for Urogynecology

  https://www.floridaurogyn.com/vaginismus/

  Inability to have intercourse, or painful intercourse, may be due to a condition known as Vaginismus. […] Vaginismus refers to the involuntary contraction of the pelvic floor muscles, the muscles in the vaginal area, in response to attempted penetration, effectively closing or significantly narrowing the vaginal opening. […] Fortunately, treatment for Vaginismus is usually very effective. […] The first-line treatment for Vaginismus is Pelvic Physical Therapy. […] Our Pelvic Physical Therapists work side by side with our medical providers to provide you with the very best treatment. […] Vaginal dilators are a set of plastic or silicone inserts to help you gradually learn how to allow penetration. […] Your therapist will teach you how to effectively relax and lengthen your pelvic floor muscles in order to allow penetration.

• #3 Vaginismus

  https://www.nhs.uk/conditions/vaginismus/

  Vaginismus is when the vagina suddenly tightens up when you try to insert something into it. It can be painful and upsetting, but it can be treated. […] Vaginismus is an automatic reaction, which you do not have control over. […] If your doctor thinks you have vaginismus, you may be referred to a specialist, such as a sex therapist. […] Treatment for vaginismus usually focuses on: managing your feelings around vaginal penetration, exercises to gradually get you used to vaginal penetration. […] Treatment is initially done under the guidance of specialised therapists. You’ll then usually be expected to practise some of the exercises at home. […] If you’re in a relationship, you can choose to involve your partner.

• #4 Management of Dyspareunia and Vaginismus | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/0415/p2511.html

  Dyspareunia and vaginismus are the two most common sexual dysfunctions in women. […] Vaginismus is a conditioned pain caused by involuntary spasm of the muscles around the lower one third of the vagina, resulting from the association of sexual activity with pain and fear. […] The immediate cause of vaginismus is involuntary spasm of the muscles around the lower one third of the vagina. […] Primary vaginismus is diagnosed in women who have never experienced vaginal penetration, while secondary vaginismus denotes prior successful vaginal penetration. […] Patients in the latter category often have been unable to complete gynecologic examinations, have difficulty using tampons and fail to present for Papanicolaou tests. […] Initial management of dyspareunia should focus on all physical causes, followed by use of a cognitive behavioral program similar to that used to treat vaginismus. […] The most successful programs help the woman feel that she owns her sexual organs and controls her sexual activity.

• #5 Vaginismus: Symptoms, Causes, Treatments, and More

  https://www.healthline.com/health/vaginismus

  Vaginismus is a type of sexual dysfunction. It occurs when the vaginal muscles involuntarily or persistently contract. While it doesnt interfere with sexual arousal, it can cause pain during sexual intercourse, making penetration difficult. […] Vaginismus is classified into two types: primary vaginismus: when vaginal penetration has never been achieved and secondary vaginismus: when vaginal penetration was once achieved, but is no longer possible, potentially due to factors such as gynecologic surgery, trauma, or radiation. […] Vaginismus is a treatable disorder. Treatment usually includes education, counseling, and exercises. […] Counseling may involve you alone or with your partner. Working with a counselor who specializes in sexual disorders may be helpful. […] Your doctor or counselor may recommend learning to use vaginal dilators under the supervision of a professional. […] Sexual dysfunction can take a toll on relationships. Being proactive and getting treatment can be crucial in saving a marriage or relationship. […] Your doctor or therapist can provide you with ways to overcome vaginismus. Many people recover and go on to live happy sexual lives.

• #6 Vaginismus: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001487.htm

  Vaginismus is a spasm of the muscles surrounding the vagina that occurs against your will. The spasm makes the vagina very narrow and can prevent sexual activity and medical exams. […] A health care team made up of a gynecologist, physical therapist, and sexual counselor can help with treatment. Treatment involves a combination of physical therapy, education, counseling, and exercises such as pelvic floor muscle contraction and relaxation (Kegel exercises). […] Vaginal dilation exercises using plastic dilators are recommended. This method helps to make the person less sensitive to vaginal penetration. These exercises should be done under the direction of a sex therapist, physical therapist, or other health care provider. Therapy should involve the partner and can slowly lead to more intimate contact. Intercourse may ultimately be possible. […] Women who are treated by a sex therapy specialist can very often overcome this problem.

• #7 Vaginismus – Florida Center for Urogynecology

  https://floridaurogyn.com/vaginismus/

  Inability to have intercourse, or painful intercourse, may be due to a condition known as Vaginismus. This condition can also make inserting tampons and gynecologic exams difficult or even impossible. Vaginismus refers to the involuntary contraction of the pelvic floor muscles, the muscles in the vaginal area, in response to attempted penetration, effectively closing or significantly narrowing the vaginal opening. […] Fortunately, treatment for Vaginismus is usually very effective. […] Your provider may recommend medications such as muscle relaxants and numbing creams to make intercourse more comfortable. Sometimes pelvic floor Botox injections may help if other treatments do not work or only work partially. While medications may help, they are not a cure. The first-line treatment for Vaginismus is Pelvic Physical Therapy.

• #8 Vaginismus | Jean Hailes

  https://www.jeanhailes.org.au/health-a-z/vulva-vagina/vulval-vaginal-conditions/vaginismus

  Vaginismus is when your pelvic floor muscles involuntarily tighten. These muscles are in the lower third of the vagina. This can happen before or during an attempt to insert something into the vagina. For example, before or during sex, when inserting a tampon or sex toy, or during a vaginal examination. […] The main sign of vaginismus is the involuntary tightening of your vaginal muscles (part of your pelvic floor muscles). This can cause symptoms of pain and discomfort with any attempted vaginal penetration. […] Vaginismus can cause some women to avoid situations where attempts at vaginal penetration might occur (e.g. dating, sex, pelvic examinations). Past experiences of pain can set up a cycle of fear of pain and muscle contraction. […] Your doctor or specialist will recommend different treatment options depending on your individual situation. Common treatments include: pelvic floor physiotherapy (e.g. pelvic floor muscle relaxation exercises, gentle massage, equipment such as biofeedback and vaginal trainers), counselling or therapy, medication to help with any persistent pain issues. […] Treatment for vaginismus may involve different health professionals such as: a doctor, a pelvic floor physiotherapist, a psychologist, a sex therapist.

• #9 Genito-Pelvic Pain/Penetration Disorder (Vaginismus) | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/816419/all/Genito_Pelvic_Pain_Penetration_Disorder__Vaginismus_

  Genito-pelvic pain/penetration disorder is the name of the conditions formally known as vaginismus and dyspareunia. Vaginismus results from involuntary contraction of the vaginal musculature. Primary vaginismus occurs in women who have never been able to have penetrative intercourse. Women with secondary vaginismus were previously able to have penetrative intercourse but are no longer able to do so. […] Persistent or recurrent difficulties for 6 months or more with at least one of the following: Inability to have vaginal intercourse/penetration on at least 50% of attempts. […] The disturbance causes marked distress or interpersonal difficulty. […] Vaginismus may be an independent risk factor for cesarean delivery. […] Most often multifactorial in both primary and secondary vaginismus. […] Although the exact role in the condition is unclear, many women report a history of abuse or sexual trauma. […] Often associated with other sexual dysfunctions.

• #10 Vaginismus Specialist in Melbourne | Dr. Len Kliman

  https://drlenkliman.com.au/services/vulval-and-vaginal-skin-disorders/vaginismus/

  Vaginismus occurs when the muscles around the vagina tighten. […] Vaginismus occurs when the muscles around the vagina tighten when something enters the vagina (a tampon, a penis or during a pelvic examination). When the muscles tighten, this can cause pain or discomfort. […] The muscle tightening often occurs as a response to previous pain, or expectation of pain or discomfort. The muscle tightening is an involuntary response which means that it is not done consciously. […] Primary vaginismus means that there has always been pain/tightness with anything in the vagina (first tampon use or first episode of sexual intercourse). Secondary vaginismus occurs when there has been no pain/tightness associated with entry into the vagina but then pain develops over a period of time. […] The cause of vaginismus is unknown. Some factors that may contribute include having pain along the opening of the vagina (localised provoked vulvodynia), recurrent bladder infections, yeast infections such as thrush, fear that anything entering the vagina might be painful, previous abuse or trauma, or injury during childbirth. In many cases no specific cause is found.

• #11 Vaginismus Specialist in Melbourne | Dr. Len Kliman

  https://drlenkliman.com.au/services/vulval-and-vaginal-skin-disorders/vaginismus/

  Common therapies include pelvic floor physiotherapy and the use of vaginal dilators or stretching, special breathing techniques and learning how to relax the pelvic floor muscles, cognitive behavioural therapy and sex therapy. Some women need more than one type of therapy and the time involved to improve the symptoms varies between women. Dr Kliman will often refer you to a physiotherapist who specialises in pelvic relaxation. Localised provoked vulvodynia can be helped significantly with the use of special creams that contain a neuromodulator (a drug that alters nerve fibre behaviour). […] It takes time and effort but many women with vaginismus improve dramatically with the appropriate treatment. There is however, no quick fix but becoming pain free again without vaginal tightening usually occurs. Even with vaginismus many women still have satisfying sexual relationships by engaging in sexual activities other than intercourse.

• #12 Component of sexual health services for vaginismus management: A qualitative study

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10411750/

  Provision of sexual health services requires gender-sensitive management, facilities, and staff, as well as planning for gender-sensitive caregivers and education. […] Couples suffering from vaginismus face many types of barriers to accessing sexual health services. […] Insufficient sex education can lead to the development of vaginismus as a sexual disorder. […] Treatment management of women with vaginismus is multifaceted and its various dimensions should be considered. […] Vaginismus treatment exercises should be easy, enjoyable, and compatible with the patients lifestyle. […] Sexual health education should be integrated into premarital education and couple empowerment which can effectively prevent vaginismus. […] Therefore, improving the quality of sex education in premarital counselling classes is another appropriate strategy which can diminish the problems of sex education in the prevention of vaginismus by providing more transparent education in this regard and also continuing education for couples after marriage.

• #13 Vaginismus: Types, Causes, Symptoms, and Treatment | Sparsh Hospital

  https://www.sparshhospital.com/blog/vaginismus/

  Vaginismus is an often misunderstood condition that can significantly impact a womans physical and emotional well-being. This involuntary response not only transforms intimate experiences into challenging and painful encounters but also makes tampon use painful or impossible. […] Vaginismus manifests as an involuntary contraction of the vaginal muscles that occurs when penetration is attempted. This can happen during sexual intercourse, tampon insertion, or gynaecological examinations. The severity of muscle spasms can vary, ranging from mild discomfort to severe pain, often making penetration difficult or impossible. […] Vaginismus is a treatable condition, says Dr. Prathima Reddy. The following are several therapeutic approaches to treat vaginismus: […] Pelvic floor physical therapy is a specialised form of vaginismus treatment. It focuses on the muscles, ligaments, and connective tissues of the pelvic area. A trained physiotherapist works with the patient to identify areas of weakness or tension in the pelvic floor muscles. By combining exercises, manual therapy, and biofeedback techniques, patients learn to relax and control these muscles consciously.

• #14 Vaginismus: Symptoms, Causes & Treatment

  https://resources.healthgrades.com/right-care/womens-health/vaginismus

  Vaginismus is a condition in which the vagina involuntarily tenses up. This could happen at the start of sexual intercourse or during a pelvic exam, or while inserting a suppository, tampon, diaphragm, or any other type of uterine device. […] Vaginismus can make sexual intercourse painful, uncomfortable or even impossible to tolerate. Visits for routine gynecological exams can become stressful, and even using tampons can be an issue. Treatments for vaginismus are available that can help decrease the frequency and discomfort, depending on the cause. […] If your vaginismus is persistent or causes you concern, seek prompt medical care. […] Symptoms of vaginismus may be occasional or persistent. Vaginismus symptoms include: Difficulty with vaginal penetration during sex, Discomfort or pain when inserting tampons, Pain with penetration or during a pelvic exam.

• #15 Vaginismus Management Through Pelvic Floor Physical Therapy

  https://www.chicagopelvic.com/blog/treating-vaginismus

  Vaginismus is defined as the involuntary spasm of the outer third layer of the pelvic floor muscles during attempted vaginal penetration. This means that the feeling of hitting a wall is real and results from the tensing or tightening of the pelvic floor muscles. […] Vaginismus is highly treatable, and Pelvic Floor Physical Therapy is a key component of treatment. PFPT involves working with a specialized physical therapist who can help you learn to control and relax your pelvic floor muscles. […] While Pelvic PT is crucial, treatment outcomes are significantly enhanced when combined with a multidisciplinary approach that includes psychotherapy. Addressing both the physical and emotional aspects of vaginismus can lead to more effective and long-lasting results. […] Treatment is highly personalized and can provide significant relief, helping you reclaim control over your body and improve your quality of life.

• #16 Vaginismus (Causes, Symptoms and Treatment)

  https://patient.info/doctor/vaginismus

  Vaginismus is defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a 'genitopelvic pain disorder and/or penetration disorder’ (GPPPD), which attempts to bring together the concepts and full spectrum of painful vaginal penetration. […] Vaginismus may be primary in nature, or secondary. If primary, the woman has never been able to have penetrative intercourse without pain, or never been able to achieve penetrative intercourse. […] In the treatment of vaginismus, male sexual dysfunction should not be ignored. Spouses should be questioned for sexual dysfunction and included in the treatment process. […] The clinician should take a careful gynaecological, obstetric, sexual and urological history to determine if there is any obvious likely cause. […] Treat any physical cause found. If a physical cause has been excluded, treatment usually consists of education, counselling and behavioural exercises.

• #17 Dyspareunia in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/0515/p597.html

  Vaginismus (involuntary contraction of the pelvic floor muscles with attempted vaginal penetration) is now combined with dyspareunia into the term genitopelvic pain/penetration disorder. Vaginismus leads to fear or anxiety about penetration, causing pelvic floor muscle constriction, which is distinct from causes of entry dyspareunia, such as infections, vulvodynia, or pelvic floor dysfunction. Primary vaginismus occurs in patients who have never had painless penetration, whereas secondary vaginismus occurs when the patient previously had painless penetration but now reports pain. Although vaginismus may be associated with anxiety, fear, traumatic sexual experiences, or medical conditions that cause painful penetration, some patients with vaginismus do not have any antecedent risk factors. […] Successful multidisciplinary treatment of vaginismus may include cognitive behavior therapy, psychotherapy, relationship and sexual counseling, vaginal lubricants, sequential vaginal dilators, and onabotulinumtoxinA injection.

• #18

  https://step2.medbullets.com/gynecology/120212/vaginismus

  A 40-year-old, recently divorced, woman presents with pain upon sexual intercourse. When attempting intercourse after her divorce, there was severe pain upon penetration, forcing her to end sexual intercourse. Upon further questioning, she reveals that she is a sexual assault survivor. On physical exam, there is involuntary vaginal muscle contractions during pelvic examination. […] Vaginismus is a sexual pain disorder […] vaginismus results in physical difficulty allowing vaginal penetration, despite willingness […] Vaginismus is the only type of sexual dysfunction that can be diagnosed with physical exam. […] Diagnosis confirmed if vaginal muscles contract involuntarily with pelvic exam. […] Treatment includes gradual vaginal dilators, physical therapy to relax the tight muscles, and counseling. […] Vaginal dilators are typically very successful.

• #19 Self-diagnosing vaginismus found accurate vs health care provider diagnosis

  https://www.contemporaryobgyn.net/view/self-diagnosing-vaginismus-found-accurate-vs-health-care-provider-diagnosis

  Self-diagnosing vaginismus found accurate vs health care provider diagnosis. The accuracy of self-diagnosis for vaginismus using a web-based list of symptoms is similar to that of a diagnosis from a health care provider (HCP). Vaginismus is a subcategory of genito-pelvic pain/penetration disorder (GPPPD), presenting as spasms of the pelvic floor muscle. Estimates of vaginismus may be low because of inadequate sexual health training among HCPs and reluctance among women to discuss their symptoms with their HCP. Therefore, an internet-based diagnostic tool may increase reach among women with GPPPD and improve care. These results indicated accuracy of self-diagnosis vaginismus using an internet-based tool when compared to an HCP diagnosis during a clinical visit. Investigators concluded a web-based tool could shorten the time it takes for patients to be diagnosed and receive care. […] Significant agreement was reported between self-diagnosis and HCP diagnosis of vaginismus.

• #20 Interventions for vaginismus

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7072531/

  Vaginismus is an involuntary contraction of the vaginal muscles which makes sexual intercourse difficult or impossible. It is one of the more common female psychosexual problems. Various therapeutic strategies for vaginismus, such as sex therapy and desensitisation, have been proposed, and uncontrolled case series appear promising. […] To assess the effects of different interventions for vaginismus. […] The ideal treatment for vaginismus must access the complex interplay between the biological, emotional, psychological and relational components of women’s and couples’ lives. […] Psychological therapies have to be conducted face to face and a minimum number of sessions is required. For vaginismus, these include combinations of systematic desensitisation including the Masters and Johnson method (in vivo, imaginal or both) together with the use of graded dilators; sex therapy including sex education (individual, conjoint or with a surrogate partner), in which a gradual approach is taken to overcoming the disorder, including education, homework assignments and cognitive therapy; relaxation therapy; hypnotherapy or pelvic-perineal reeducation combined within cognitive behaviour therapy.

• #21 Clinical assessment and management of vaginismus

  https://www1.racgp.org.au/ajgp/2024/january-february/clinical-assessment-and-management-of-vaginismus

  Vaginismus is one of the leading causes of painful sex (dyspareunia) for women. General practitioners (GPs) play a vital role in diagnosing and treating vaginismus, as well as coordinating a multidisciplinary team to support people with vaginismus. […] GPs play a vital role in helping people recover from vaginismus through validating peoples experiences, making an accurate diagnosis and making referrals to other relevant health professionals. GPs can also offer a range of treatment options for people with vaginismus. While the management of vaginismus can be time-consuming and take some trial and error, multidisciplinary care with multimodal therapy often results in positive patient outcomes. […] The latest clinical practice guideline on female sexual dysfunction recommends an individualised, multidisciplinary approach for vaginismus, tailored according to an individuals underlying contributing factors and any existing comorbidities. […] Successful treatment of vaginismus is generally multidisciplinary and involves a combination of patient education, pelvic floor muscle relaxation, use of vaginal trainers and psychological therapy.

• #22 Vaginismus: Symptoms, Causes, & Treatments | Mid Ulster Clinic

  https://midulsterclinic.com/symptoms/vaginismus/

  Therapies, particularly cognitive-behavioural therapy (CBT), can be hugely beneficial when psychological factors like anxiety or past trauma are involved. Therapy can help individuals address the emotional and mental aspects of the condition and develop healthy coping mechanisms to reduce the fear associated with penetration. […] For more severe cases, medical interventions might be necessary. The use of vaginismus dilators is a common method to gradually desensitise the vaginal muscles. These dilators, available in various sizes, are used to gently stretch the vaginal muscles, helping to reduce the tightness and pain over time. […] Addressing vaginismus early not only alleviates symptoms like pain and discomfort but also improves overall well-being, allowing you to regain confidence and enjoy a healthier, more fulfilling life.

• #23

  https://lotusptny.com/blog/how-to-treat-vaginismus-physical-therapy-tips-for-lasting-relief

  Pelvic floor exercises aim to relax and strengthen the muscles surrounding the vagina. While Kegel exercises are commonly associated with pelvic floor training, vaginismus treatment requires a different approach, often involving muscle relaxation techniques rather than strengthening. A pelvic health therapist can guide you through specific exercises tailored to release tension in overactive muscles, helping to reduce spasms. […] Vaginal dilators are a key tool in vaginismus treatment, used to gently stretch the vaginal muscles and decrease sensitivity. The process involves starting with the smallest dilator and gradually progressing to larger sizes as comfort increases. Under the guidance of a pelvic health therapist, this technique helps desensitize the area and reduce anxiety associated with penetration.

• #24 Vaginismus – Florida Center for Urogynecology

  https://www.floridaurogyn.com/vaginismus/

  Biofeedback gives a visual of how well you are able to relax your pelvic floor muscles. […] Hands-on techniques can help you relax your pelvic floor muscles more effectively. […] Your therapist will provide you with a comprehensive home exercise program that you will practice between sessions. […] Your therapist will help you understand your condition and your body, what you can do to ensure a full recovery, as well as the many resources that are available to you.

• #25

  https://lotusptny.com/blog/how-to-treat-vaginismus-physical-therapy-tips-for-lasting-relief

  Following the consultation, the next phase involves engaging with specialized care through a pelvic physical therapist. These experts are uniquely trained in addressing pelvic floor conditions, including vaginismus. At this stage, we focus on evaluating your specific situation. […] A personalized treatment plan plays a key role in your vaginismus management journey. Here, aspects like core stabilization and breathing techniques often take center stage: Breathing can help with relaxation and control, aiding in releasing tension that contributes to involuntary spasms, Core stabilization exercises help build a supportive structure for your pelvic floor. […] Physical therapy plays a significant role in managing vaginismus by focusing on relieving muscle tension, improving flexibility, and reducing anxiety. Here are some key techniques used in physical therapy to treat vaginismus:

• #26 Vaginismus: Dyspareunia, Causes, Symptoms, Treatment

  https://my.clevelandclinic.org/health/diseases/15723-vaginismus

  Vaginismus treatments focus on reducing the reflex of your muscles that causes them to tense up. Treatments also address anxieties or fears that contribute to vaginismus. […] Your healthcare provider may recommend one or more of these treatments: […] Vaginal dilator therapy: Vaginal dilators are tube-shaped devices that come in various sizes. Their primary purpose is to stretch the vagina. People with vaginismus use dilators to become more comfortable with, and less sensitive to, vaginal penetration. […] If you experience muscle spasms or pain that makes intercourse uncomfortable or impossible, dont be embarrassed to talk to your healthcare provider. You dont have to keep suffering. Many problems, including vaginismus, can cause painful intercourse. Almost all of these problems are treatable. A lot of people see significant improvements in their sex lives and their mental health after vaginismus treatments.

• #27 Vaginismus | Intimate Wellness Institute

  https://iwiva.com/intimate-wellness/vaginismus/

  Vaginismus is the involuntary tensing or contracting of muscles around the vagina. […] These unintentional muscle spasms occur when something a penis, finger, tampon or medical instrument attempts to penetrate the vagina. The spasms may be mildly uncomfortable or very painful. […] Vaginismus symptoms may appear during the late teen years or early adulthood when a person has sex for the first time. The condition can also happen the first time a person tries to insert a tampon or has a pelvic exam at a healthcare providers office. […] Some standard therapies we offer include: Topical therapy: Topical lidocaine or compounded creams may help with the pain associated with this condition. […] Vaginal dilator therapy: Vaginal dilators are tube-shaped devices that come in various sizes. Their primary purpose is to stretch the vagina. People with vaginismus use dilators to become more comfortable with, and less sensitive to, vaginal penetration.

• #28 Interventions for vaginismus

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7072531/

  Systematic desensitisation (in vivo, imaginal or both), together with the use of graded dilators, is a behaviour therapy technique often used for the treatment of vaginismus in which deep muscle relaxation and gradually inserting a dilator or finger into the vagina is used to reduce the anxiety and fear associated with penetration. […] The findings of this review have limited clinical implications because of the small number of trials, and the heterogeneity of protocols and patients included in the analysis. Our main finding indicates that there is no statistically significant difference between systematic desensitisation and any of the control interventions, with the exception of dropouts, in the systematic desensitisation versus waiting list comparison. It is important to mention that the current review is limited by the evidence available and, as such, conclusions about the efficacy of interventions in the treatment of vaginismus should be drawn cautiously.

• #29 How To Use a Vaginal Dilator | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/patient-education/how-use-vaginal-dilator

  Vaginal dilator therapy will help keep your vagina from becoming too narrow. It can also help keep your vagina elastic. These things will: […] The goal of vaginal dilator therapy is to increase the size of your dilators slowly. When you can insert one size of a dilator completely into your vagina without any discomfort, you should start using the next size up. The goal is to insert the largest size dilator without any discomfort, if possible. Increasing the size over time will help you have more comfortable pelvic exams, vaginal sex, or both. […] You should do dilator therapy 3 to 4 times per week, but dont do it 2 or more days in a row. Doing dilator therapy many days in a row may cause pain or irritation. Try to do Kegel exercises on the days you dont use your vaginal dilator. Kegel exercises shouldnt be painful.

• #30 Vaginismus: Symptoms, Causes & Treatment

  https://resources.healthgrades.com/right-care/womens-health/vaginismus

  This level of discomfort and pain is not normal and should be discussed with a physician to determine available treatment options. […] Treatment for vaginismus depends on the cause, which can be physical, emotional, or a combination of the two. […] Possible vaginismus treatments include: Topical medications, Vaginal dilation, Kegel exercises, Sex therapy, Cognitive behavioral therapy (CBT), Talk therapy. […] While vaginismus is not a serious medical condition, the symptoms can cause significant disruption to quality of life. Loss of intimacy can affect relationships with a partner or spouse, resulting in depression, anxiety, or loss of self-esteem. […] For women who wish to become pregnant, vaginismus may make conception impossible due to the inability to tolerate vaginal penetration.

• #31 Vaginismus: Types, Causes, Symptoms, and Treatment | Sparsh Hospital

  https://www.sparshhospital.com/blog/vaginismus/

  Vaginal dilators are cylindrical devices of gradually increasing sizes used to help women with vaginismus become more comfortable with vaginal penetration. The process, known as dilation therapy, involves inserting these devices into the vagina for short periods, typically starting with the smallest size and progressing to larger ones as comfort increases. This systematic desensitization helps the body learn that penetration can be safe and pain-free. […] Cognitive Behavioural Therapy is a form of psychotherapy that addresses the mental and emotional aspects of vaginismus. The objective is to identify and change negative thought patterns and behaviours associated with penetration. A therapist helps the patient explore and challenge fears, anxieties, and misconceptions about sex and intimacy. CBT often includes education about sexual health, relaxation techniques, and coping strategies.

• #32 Vaginismus (Causes, Symptoms and Treatment)

  https://patient.info/doctor/vaginismus

  Where the goal is for the woman to be more comfortable with her genitals, relaxation techniques and self-exploration of the genitals and insertion of 'vaginal trainers’ can be used. […] If she is in a relationship, a sensate focus programme may be offered to the couple. […] Other psychological and behavioural therapies used include cognitive behavioural therapy (CBT), relaxation therapy and hypnotherapy. […] Couples may refer themselves for sexual counselling to a service such as 'Relate’. […] Lidocaine or bupivacaine is sometimes used where pain is a principal problem. […] Topical oestrogen may be useful when vulvovaginitis is a causative factor, in the absence of systemic symptoms. […] A 2020 study found that patients are likely to have a worse prognosis if they have a history of vaginismus among relatives, or when one of the couple either takes complete responsibility for the issue, or blames the other partner.

• #33 Vaginismus – Obstetrics and Gynecology | Northwell Health

  https://www.northwell.edu/obstetrics-and-gynecology/conditions/vaginismus

  Vaginismus is an uncomfortable disorder in which the muscles in the vagina involuntarily squeeze or spasm when something is entering it. This can happen when using a tampon or attempting to have intercourse. This often inhibits women from enjoying intimacy. Patients usually have muscles that are tight as a baseline but then drastically contract when entry is attempted. […] Our professionals understand that vaginismus is a complex, personal disorder. You can feel comfortable knowing that treating vaginismus is one our specialties. In fact, Northwell Health is one of only two centers in the nation trained in the Pacik method to perform Botox injection of the pelvic floor and vaginal muscles to treat vaginismus. These injections help to lessen the amount of muscle spasms. […] You can rely on the knowledge of our specialists and multidisciplinary team to care for every facet of your condition from beginning to end. That means personal one-on-one care with the physician, muscle training and sexual counseling with trained practitioners, and for some connecting you with our physical therapists to give you the comprehensive and personalized care you deserve.

• #34 Vaginismus – Obstetrics and Gynecology | Northwell Health

  https://www.northwell.edu/obstetrics-and-gynecology/conditions/vaginismus

  Vaginismus is considered to be one of the most treatable sexual disorders. Effective treatment approaches include: Vaginal dilation under anesthesia with Botox injection of the pelvic floor and vagina. This procedure involves gentle sedation and Botox injections, which are used to relax the vaginal muscles. The injections are used in conjunction with a dilator, which helps stretch the muscles. Your physician will also check for any dermatologic causes of discomfort at the entrance of the vagina. […] Outpatient dilator and pelvic floor relaxation training with a physicians assistant, nurse practitioner or physical therapist. […] Medication to assist with muscle relaxation. […] Life management coaching to help with stress, tension or emotional issues that may worsen vaginismus. […] Treating any cause of pain which is causing or worsening vaginal spasm.

• #35 Vaginismus: Types, Causes, Symptoms, and Treatment | Sparsh Hospital

  https://www.sparshhospital.com/blog/vaginismus/

  These techniques can help individuals become more attentive to their bodys responses and learn to relax tense muscles consciously. These include deep breathing exercises, progressive muscle relaxation, guided imagery, and meditation. For vaginismus patients, these practices can help reduce overall anxiety and teach them to recognise and release tension in the pelvic area. […] In some cases of vaginismus, doctors may recommend the use of topical anaesthetics to help manage pain during penetration attempts. These are typically creams or gels containing numbing agents that are applied to the vaginal area before sexual activity or medical examinations. These anaesthetics can help break the pain-fear cycle associated with vaginismus by reducing sensation in the area. […] Vaginismus is a medical condition and can have profound effects on a womans quality of life. While it can be a challenging experience, it is necessary to understand that effective treatments are available. With proper medical intervention and support, many women can overcome vaginismus and reclaim their sexual health and well-being.

• #36 How To Use a Vaginal Dilator | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/patient-education/how-use-vaginal-dilator

  Vaginal moisturizers (such as Replens, HYALO GYN, and Revaree) are products you can use regularly to increase the moisture in your vagina. This can make dilator therapy, sexual activity, and pelvic exams easier. Vaginal moisturizers are especially helpful if youre in menopause or are taking medications that can lower your estrogen levels.

• #37

  https://www.singhealth.com.sg/patient-care/conditions-treatments/vaginismus

  Vaginismus is a condition where there is involuntary tightness of the vagina during attempted intercourse. The tightness is actually caused by involuntary contractions of the muscles surrounding the vagina entrance and outer third of the vagina. Women are often not consciously squeezing the vagina muscles as it is an involuntary response. […] Successful vaginismus treatment does not require drugs, surgery, hypnosis or any other complex invasive technique. […] First line measures such as education about the vagina structures, use of lubricants and ensuring adequate foreplay will be given. […] If vaginismus still persists after medical issues have been addressed or if the patient does not respond to first line measures, intervention sessions with a Psychologist and/ or Physiotherapist can be considered. A combination of the treatment approaches listed below may be used to optimise effectiveness: Pelvic floor control exercises, Vagina insertion or dilation training, Pain elimination techniques, Transition steps, Exercises designed to help women identify, express and resolve any contributing emotional components through counselling and psychotherapy. […] Vaginismus is treatable. Vagina discomfort and penetration difficulties from vaginismus are treatable. With compliance to treatment, women experiencing difficulties with intercourse can overcome vaginismus and achieve pain-free, pleasurable intercourse.

• #38 Vaginismus Treatment: A Guide to Take Control

  https://www.doctorsofsouthmelbourne.com.au/vaginismus-vulvodynia/

  Exercises to help relieve vaginismus symptoms aim to improve muscle control and flexibility, encourage relaxation, and enhance blood flow. […] While being treated, you can enjoy the many forms of non-penetrative sex. […] A break from penetrative sex may also help re-introduce the concepts of arousal and desire that may have faded. […] Patients often find this approach leads to improved attitudes towards sex and a gradual reduction in vaginismus symptoms. […] If painful sex or vulva are impacting your happiness and there’s no apparent cause, get to your GP as soon as possible. […] We can help diagnose the problem while identifying any underlying conditions contributing to your symptoms.

• #39 Vaginismus Treatment – PelvicSanity

  https://www.pelvicsanity.com/vaginismus

  Find Lasting Relief from Vaginismus Finally resolve your vaginismus, pain with intercourse, inability to insert a tampon or tolerate a medical exam with caring, specialized pelvic floor physical therapy. […] If you’ve been diagnosed with vaginismus (or suspect you have it), you’ve likely had a frustrating, confusing or sometimes traumatizing time getting answers. […] The root cause of vaginismus or pain with intercourse is almost always found within the pelvic floor. […] We want to help you find lasting relief from vaginismus or pain with sexual activity. […] Not only do we want to relieve your symptoms, but resolve the underlying 'why’ so they don’t return. […] At PelvicSanity, we specialize in resolving pelvic floor conditions like vaginismus, vulvodynia, painful intercourse and more.

• #40 Vaginismus Symptoms and Treatment – Hands on Healthcare

  https://hands-onhealthcare.com/vaginismus/

  Vaginismus is an involuntary, instantaneous tightening (spasm) of the muscles of the pelvic floor: This spasm causes the vaginal opening to become constricted making penetration painful or impossible. […] The pain associated with vaginismus is not in the woman’s head, and it does not respond readily to suggestions such as relax don’t think about it, and just do it. […] Vaginismus is a real physical pain that needs psychophysical intervention for diffusing the fear of penetration. […] At Orthopedic TMJ Physical Therapy Center, we establish a safe environment to discuss your concerns. […] With your healthcare provider’s referral, we discuss your options for physical therapy treatment. These options may include biofeedback, manual therapies, exercise, and use of dilators. […] Secrecy and silence about having this condition is typical of most vaginismus sufferers and is the main reason they feel that they suffer alone. […] At Orthopedic TMJ Physical Therapy Center, we understand this condition and enjoy working to educate women in a safe, caring environment.

• #41 Living with Vaginismus: Gynecologist on Receiving Care

  https://mydoctor.kaiserpermanente.org/mas/news/living-with-vaginismus-gynecologist-on-receiving-care-2487999

  For patients living with vaginismus, it can be painful to receive routine care. Virginia ob-gyn Deepali Kothary, MD, explains how patients living with vaginismus can receive the care they need in a conversation with The Washington Post. […] Informing your healthcare team that you have vaginismus is the first step to eliminating barriers to care, Dr. Kothary said. She explained that giving patients control throughout the exam is important. „Tell [patients] that they are the boss of their body. So any time they want to stop, we just stop,” she explained. […] Ob-gyns should be in constant communication with the patient throughout the entire procedure. […] Dr. Kothary shared that patients with vaginismus can try over-the-counter pain medication before the exam, and that she takes extra steps to make her patients comfortable, applying local numbing cream, using a smaller tool and encouraging her patients to listen to music, or use heating pads to feel more comfortable during exams.

• #42

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uf8637

  Vaginismus is a spasm of the muscles around the opening to the vagina. This spasm can make sex painful and even impossible. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. […] Follow any directions your doctor gives you on how to widen, or dilate, your vaginal opening. […] Call your doctor or nurse advice line now or seek immediate medical care if: You have severe vaginal bleeding. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if: You do not get better as expected.

• #43

  https://lotusptny.com/blog/how-to-treat-vaginismus-physical-therapy-tips-for-lasting-relief

  Stress and anxiety can exacerbate vaginismus symptoms, making it important to integrate relaxation techniques into your daily life. Mindfulness practices such as yoga, meditation, or breathing exercises can help manage stress levels and reduce muscle tension. […] If you are in a relationship, addressing vaginismus together can improve both intimacy and support. Discuss your treatment goals with your partner, set boundaries for physical activity, and explore non-penetrative forms of intimacy that prioritize your comfort. […] Keeping a journal to track your experiences, symptoms, and milestones can provide valuable insights into your treatment journey. […] Joining a support group or online community for women experiencing vaginismus can be a valuable source of encouragement. Hearing others share their experiences can offer practical tips and emotional reassurance that you’re not alone.

• #44 Fast Facts: What You Need to Know About Vaginismus – HealthyWomen

  https://www.healthywomen.org/your-health/your-body/what-you-need-know-vaginismus

  Treatment methods for vaginismus can help get rid of its painful and scary symptoms. Treatments focus on managing any negative emotions that surround vaginal penetration. […] These treatments seem very different from one another, but all focus on stopping the painful, involuntary muscle spasm. […] Vaginismus can affect your sex life, relationships and self-confidence. […] It takes bravery to communicate your needs with your partner and HCPs, and treatment takes patience. You can regain control of your body and it’s never too late to ask for help. […] Not all gynecologists are trained in the diagnosis and treatment of vaginismus.

• #45 Fast Facts: What You Need to Know About Vaginismus – HealthyWomen

  https://www.healthywomen.org/your-health/your-body/what-you-need-know-vaginismus

  If your vagina won’t let anything in, you’re not broken. You may have vaginismus. Read what you can do to help. […] Vaginismus can be frustrating, distressing and painful, but there are many treatment options to help you regain control, comfort and even pleasure. […] Vaginismus often causes pain during sexual activity, and it can even make inserting tampons, gynecologic exams or intercourse impossible. […] Because vaginismus causes painful sex, it is a type of dyspareunia the medical term for persistent pain before, during or after sexual intercourse. […] Fortunately, people with vaginismus can still experience orgasms from clitoral stimulation and getting treatment can restore their ability to enjoy penetrative sex. […] Overcoming the stigma of discussing sexual dysfunction is the first step to treating vaginismus.

• #46

  https://www.sgh.com.sg/patient-care/conditions-treatments/vaginismus

  A combination of the treatment approaches listed below may be used to optimise effectiveness: Pelvic floor control exercises, Vagina insertion or dilation training, Pain elimination techniques, Transition steps, Exercises designed to help women identify, express and resolve any contributing emotional components through counselling and psychotherapy. […] Our healthcare providers will give an initial assessment with follow-up outpatient sessions. […] Vaginismus is treatable. Vagina discomfort and penetration difficulties from vaginismus are treatable. With compliance to treatment, women experiencing difficulties with intercourse can overcome vaginismus and achieve pain-free, pleasurable intercourse.

• #47 Vaginismus: Types, Symptoms, Causes, Diagnosis, Treatment and More

  https://www.health.com/vaginismus-overview-7377046

  General psychotherapy is typically used when your healthcare provider suspects an underlying psychological issue that is causing your vaginismus. […] Sex therapy often includes a combination of sex education, cognitive behavioral therapy, and physical therapy with vaginal dilation. You’ll work with a trained sex therapist to specifically address sexual dysfunction related to vaginismus. […] Research shows the severity of your symptoms may affect treatment. Milder cases of vaginismus can be treated successfully with the help of treatments such as physical therapy or psychotherapy. However, treatment options for severe symptoms may involve multiple therapies, including Botox injections.

• #48

  https://www.intimaterose.com/pages/vaginismus?srsltid=AfmBOoo7-KGkHy3iJPDaIGtcL0CpFWx_Q0M6cPTEUKWfXoTlPtf9Q0_j

  For this reason, counseling may be beneficial while working on training the body. Anxiety, stress, pain, and fear of pain often reinforce the symptoms of vaginismus. […] The process of curing vaginismus involves learning to sense when the muscles spasm, and training the brain to relax them prior to the contraction starting via vaginismus exercises. […] The best form of treatment for vaginismus can vary from person to person, depending on the underlying causes, symptoms, and personal preferences. Treatment often involves a multi-disciplinary approach that may include medical, physical, and psychological interventions. […] Learning to breathe properly is an important part of healing pelvic and vaginal pain. […] This exercise of clenching, unclenching, and noticing the sensation of relaxation is important because it gives your brain information. This information allows you to be more aware of clenching patterns that may arise throughout your day during times of stress, anxiety, or pain.

• #49 Relief from Vaginismus | Origin

  https://www.theoriginway.com/treatments/vaginismus

  Whether youre struggling to have penetrative sex or want to be able to use a tampon or get a pelvic exam without pain, we’re so glad you’re here. Our PTs have helped hundreds of patients address vaginal pain and feel better in their bodies. […] Your treatment plan will be personalized to your symptoms, circumstances, and goals. It may include: Manual therapy to relieve tissue pain and tension, Regaining awareness of your pelvic floor, Breathing and other tension-relieving techniques, Vaginal dilators/trainers. […] Research shows that 45% of patients who see a PT for vaginismus report improvement in symptoms. […] Vaginismus is a condition where the muscles of the pelvic floor that surround the vagina, opening are unable to relax. This can make inserting a tampon, gynecological exams or penetrative sex very painful. Primary vaginismus occurs when the pain has always been present, while secondary vaginismus can develop following a specific event like trauma, infection, or menopause.

• #50 How to Treat Vaginismus At Home

  https://www.worthitpt.com/post/how-to-treat-vaginismus-at-home

  Vaginismus is where the muscles in your pelvic floor, particularly the ones around your vulva and vagina, spasm or involuntarily close making penetration either completely impossible or severely difficult. […] Symptoms of vaginismus include muscle spasms and inability to penetrate vaginal cavity. […] Treating Vaginismus should be a multimodal approach with the team consisting of you, your OBGYN, your Pelvic Floor Physical or Occupational Therapist, and your mental health therapist or sex therapist. […] The traditional treatments include: Dilator Therapy: This should only be used in conjunction with some type of physical therapy where they can confirm this treatment will be helpful for you. […] As discussed previously, this isn’t a life long condition but it can be complex. […] It is helpful, again, to think of this like running a marathon. It will take time, a plan, consistency, and support but it is completely possible to achieve with all of these elements. […] Vaginismus is completely treatable, and yes, you can treat it at home with the right knowledge and resources.

• #51 Relief from Vaginismus | Origin

  https://www.theoriginway.com/treatments/vaginismus

  Pain with vaginal penetration is most often due to dysfunction in the tissue or muscles that surround the vaginal opening. Inadequate lubrication can lead to dryness and irritation of the vaginal canal, while spasms in the pelvic floor muscle layers can decrease the size of the vaginal opening making penetration painful or impossible. […] Depending on the source of the pain, symptoms can improve with pelvic floor physical therapy within weeks or months. Since the pelvic floor muscles may be in spasm for years before discovery, as in the case of primary vaginismus, it can take as many as 20 weekly visits to retrain and lengthen the pelvic floor.

• #52 Vaginismus: Classification, Diagnosis, Etiology and Treatment

  https://www.medscape.com/viewarticle/730325

  Vaginismus is currently defined as an involuntary vaginal muscle spasm interfering with sexual intercourse that is relatively easy to diagnose and treat. […] Interestingly, the few empirical studies that have been conducted on vaginismus do not support the view that it is easily diagnosed or treated and have shed little light on potential etiology. […] This article suggests that vaginismus cannot be easily differentiated from dyspareunia and should be treated from a multidisciplinary point of view. […] Current treatment options for vaginismus include pelvic floor physiotherapy, pharmacological treatments, general psychotherapy and sex/cognitive behavioral therapy. […] The success rates for the various treatments have generally been reported to be excellent despite the lack of randomized controlled treatment outcome studies validating this claim.

• #53 Component of sexual health services for vaginismus management: A qualitative study | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0283732

  Efficient sexual health clinics refers to therapist skills, sexual therapist empowerment, structural features of sexual health clinics, and cultural considerations in establishing sexual health clinics. […] Protocol for management and treatment of sexual problems refers to sexual education and counseling content, treatment requirements, and approaches to sex education. […] Based on the results of the present study, comprehensive preventive sex education through the education system and the Ministry of Health can improve the attitudes of adolescents and young people and prevent sexual problems such as vaginismus to a large extent. […] Therefore, it is recommended that the Ministry of Health, Treatment, and Medical Education and other related organizations provide health, counselling and treatment services, establish, equip, and expand specialized centers in this area; and create a referral system to these centers in the general body of health services.

• #54 Vaginismus: Classification, Diagnosis, Etiology and Treatment

  https://www.medscape.com/viewarticle/730325

  To date the only randomized controlled treatment outcome study that investigated the efficacy of cognitive behavioral sex therapy for vaginismus does not support the notion that vaginismus is an easily treatable condition. […] A multidisciplinary diagnostic and adequate treatment approach for vaginismus addressing fear, genital pain, pelvic floor muscle tension and sexual pleasure is recommended.

• #55 Vaginismus: What it is and What to Do About It

  https://drbrighten.com/vaginismus-treatment/

  Vaginismus is a type of sexual pain disorder characterized by involuntary muscle spasms in the pelvic floor that make vaginal penetration of any kind painful or impossible. Someone with symptoms of vaginismus can’t control these spasms, and the pain can range from mild to extreme. It can seriously disrupt relationships, quality of life, and self-esteem. Painful intercourse is only one sign of vaginismus. […] The good news is that vaginismus is a treatable condition. […] Vaginismus can impact your quality of life, causing serious stress in relationships and self-esteem. […] Vaginismus has a high treatment success rate even compared to other sexual pain disorders. […] The most effective vaginismus treatments include pelvic floor physical therapy, vaginal dilators, psychological support, mind-body therapies, trigger point therapy, and at home exercises. […] With the right support and treatment, vaginismus is curable. […] Working with a licensed healthcare provider who is experienced in the treatment of vaginismus is key in helping resolve this condition.

• #56 Vaginismus Treatment – PelvicSanity

  https://www.pelvicsanity.com/vaginismus

  Our mission is to help patients with complex conditions find true, lasting relief in a safe, supportive environment. […] We’ve helped thousands of patients with vaginismus, vulvodynia, painful intercourse or other pelvic pain, both locally here in Southern California and those who have travelled to us for expert care. […] More than 70% of our patients have been to other pelvic health facilities before finding relief here at PelvicSanity. […] You deserve expert care. At PelvicSanity, you’ll work with a specialist who has dedicated their career solely to pelvic health. […] We want to help you find lasting relief by discovering the root cause of symptoms, so they won’t continue to come back. […] A whole body approach is necessary for true, lasting relief. […] You won’t be hearing high school kids grunting as they exercise right outside the door, struggle with parking or have to enter a hospital facility for each visit. […] We work with the most complex patients who fly in from care from all over the world. […] You deserve to get back to what you love, confident in your pelvic health.

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