Vaginismus and subfertility: case reports on the association observed in clinical practice

  • Ramli M
  • Nora MZ
  • Roszaman R
  • Hatta S
Keywords: Case reports, vaginismus, infertility, psychological approach, Malaysian women

Abstract

Objective: To analyse the features of patients with vaginismus first presented to a gynaecologist for infertility before being referred for psychiatric evaluation and management. The case series aim to provide some insight on features and presentations of Asian women with vaginismus. Vaginismus is characterised by persistent or recurrent difficulties in vaginal penetration despite the woman’s wish for coitus. Avoidance, phobia, anticipatory fear of pain and involuntary pelvic muscle contraction are the most common symptoms.
Method: We report a series of cases of Malaysian women who had been suffering from vaginismus and ‘infertility’. All the cases had never been attended to medically and there were long delays in seeking intervention. There was no history of traumatic sexual experience or any major psychiatric illness in these patients. Majority of the patients had prominent symptoms of anxiety.
Conclusion: The cases illustrate that it is important to rule out the possibility of vaginismus among patients with infertility. The former have unique psychological features which require psychological interventions.

References

American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Text revised. American Psychiatric Association: Washington, DC; 2000. p. 503.

Michetti PM, Rossi R, Bonanno D, et al. Male sexuality and regulation of emotions: a study on the association between alexithymia and erectile dysfunction (ED). Int J Impot Res. 2006;18(2):170-4.

Reissing ED, Binik YM, Khalife S, et al. Etiological correlates of vaginismus: sexual and physical abuse, sexual knowledge, sexual self-schema, and relationship adjustment. J Sex Marital Ther. 2003;29(1):47-59.

Graziottin A. Etiology and diagnosis of coital pain. J Endocrinol Invest. 2003;26(3 Suppl):115-21.

Nusbaum MR, Gamble G, Skinner B, et al. The high prevalence of sexual concerns among women seeking routine gynecological care. J Fam Pract. 2000;49(3):229-32.

Lewis RW, Fugl-Meyer KS, Bosch R, et al. Epidemiology/risk factors of sexual dysfunction. J Sex Med. 2004;1(1):35-9.

Crowley T, Goldmeier D, Hiller J. Diagnosing and managing vaginismus. BMJ. 2009;338:b2284.

Reissing ED, Binik YM, Khalife S, et al. Vaginal spasm, pain, and behavior: an empirical investigation of the diagnosis of vaginismus. Arch Sex Behav. 2004;33(1):5-17.

Ohkawa R. Vaginismus is better not included in sexual pain disorder. J Sex Marital Ther. 2001;27(2):191-2.

Sidi H, Puteh SE, Abdullah N, et al. The prevalence of sexual dysfunction and potential risk factors that may impair sexual function in Malaysian women. J Sex Med. 2007;4(2):311-21.

Naeimeh T, Seyed MYA. Incidence and prevalence of the sexual dysfunctions in infertile women. Eur J Gen Med. 2009;6(2):74-7.

Jeng CJ, Wang LR, Chou CS, et al. Management and outcome of primary vaginismus. J Sex Marital Ther. 2006;32(5):379-87.

Munasinghe T, Goonaratna C, de Silva P. Couple characteristics and outcome of therapy in vaginismus. Ceylon Med J. 2004;49(2):54-7.

Harrison CM. Vaginismus. Contracept Fertil Sex. 1996;24:223-8.

Masters WH, Johnson VE. Human sexual inadequacy. London: Little, Brown; 1970;1:5-15.

Blazer JA. Married virgins: a study of unconsummated marriages. Journal of Marriage and the Family. 1964;2:213-4.

Ferrero S, Esposito F, Abbamonte LH, et al. Quality of sex life in women with endometriosis and deep dyspareunia. Fertil Steril. 2005;83(3):573-9.

Published
2012-06-01
How to Cite
MR., MZN., RR., & SH. (2012). Vaginismus and subfertility: case reports on the association observed in clinical practice. Malaysian Family Physician, 7(1), 4. Retrieved from https://www.e-mfp.org/ojs3/index.php/MFP/article/view/17
Section
Original Articles