Vaginismus or very tight vagina. It is a psychologically involuntary spasm or shut of Vaginal or around muscles in genital area in women which also results in painful sex.
This results in difficulty for penis penetration and hence a sexual intercourse in couple. Such women avoid the Internal Gynecological Exams or Screening.
Such women are mostly with history of sexual painful or unpleasant intercourse or infertility.

Vaginismus could be of 2 types – Primary & Secondary.

Primary Vaginisimus – It happens when nothing has entered into the woman’s vagina ever. However, vagina is normal anatomically and functional too. Common cause is a psycho-sexual in origin. The often presence of a subconscious fear of pain, hymen break, bleeding and so on in newly wedded wives.

Secondary Vaginismus – It happens following childbirth or other event in life. There usually Vaginal painful
tears , vaginal injury, hymen injury, scars and narrow small vaginal opening.

Any of mentioned reasons could be very temporary and they are relieved / treated .
Treatment :
1. Psychodynamic Therapy

Main cause of concern , fear, agitation, anxiety and discomforts could be discussed and explained in details over a sympathetic consultation.
– Education on female body – anatomy, structures, functions and sexual intercourse.
– Adequate guidance and reassurance for the complaints.
– Couple Counseling and partner education is a very important aspect of the treatment.
– Positive approach for normal sexual life should be discussed.
– Partner co-operation is the definite crucial part in the treatment.

2. Behavioural Therapy
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– Use of lubricated fingers,Vaginal Dilators (gradually increase in size ), vaginal plastic trainer (pseudo-penis) with
local lubricants or anaesthetic ointments under the physician advice.

3. Ayurveda

– Anxious and stressed patients could have calming Shiro Dhara, Shiro Basti , Nasyam, stress relieving medications and few more.

4. Surgery

– In extreme or reluctant cases of conditions when hymen is found very tight and not responding to other conservative treatment, surgery is the option – Hymenectomy opr Fentor’s operation.

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