Vaginismus

This paper considers the relevance of de Beauvoir's work for clients with 'vaginismus'. Focusing on women's relationships to their bodies, partners, and being-for-others more widely, it links de Beauvoir's theories to more recent research, and to a key case study. The importance of therapist awareness of shifting gender roles is highlighted.

Falls Sex ein Thema in Ihrem Leben ist – sei es, weil er zu oft, zu selten, gehemmt, schmerzhaft oder unbefriedigend, monoton oder exzentrisch oder gar nicht stattfindet – dann lesen Sie einfach dieses Buch. Viele Menschen beschäftigen Fragen wie diese: War ich gut? Was hält sie/er von mir? Bin ich ein guter Liebhaber? War der Orgasmus echt? Oh nein, nicht schon wieder! Hoffentlich klappt es heute! Wenn ich nur nicht wieder so schnell komme! Wie sag ich ihr/ihm, dass ich keine Lust habe? In diesem Selbsthilferatgeber hat die Sexualtherapeutin Dr. med. Barbara Laimböck Erfahrungen und Interventionen von 30 Jahren ärztlicher Tätigkeit mit Hypnosetherapie gesammelt. Sie erzählt Ihnen dazu Fallgeschichten, die therapeutische Wirkung erzielen. Auch Paarübungen stehen zur Verfügung. Probieren Sie es einfach aus und überraschen Sie die/den Partner*in.

Physiotherapy for the treatment of vaginismus is perceived as an intervention aimed to normalize muscle tone of the pelvic floor in order to allow vaginal penetration in accordance with the traditional view of vaginal spasm as its defining feature. Newer definitions recognize the experience of anxiety as well as pain, and effective treatment approaches should address these components as well. Physiotherapists often encounter women who, as a result of severe anxiety, are unable to undergo examination and treatment, despite their expressed desire to do so. This article describes a therapeutic intervention designed to help women with vaginismus prepare for examination and treatment by addressing the component of anxiety in real-life situations. This approach is also appropriate for nurse practitioners and physicians who work with this patient population and may be adapted for sex therapists to teach as a home exercise

Vaginismus is a relatively rare female sexual dysfunction, but with significant disabling potential. Vaginismus can be defined as involuntary spasms of the muscles surrounding the vaginal opening. Its severe form makes it impossible to penetrate and causes severe pain, burning sensations. As early as 1547, when vaginismus was first described, and to this day, it continues to be an intensely researched topic, with thousands of papers published. However, the etiology of vaginismus remains controversial. Vaginismus has been shown to be a sexual disorder that has phobic elements resulting from patients' actual or imagined negative sexual experiences. Most women who suffer from vaginismus express their fear and anxiety about the act of penetration, generally feel ashamed or disgusted with their genitals.

It was three times refused by reviewers of sexology journals. We are still enthusiastic about the subject matter, and the plea for more attention towards clinical studies, including n=1 case reports. Academia is a welcome opportunity to present the text to the scientific community.]Summary: Objective. Conceptualization and classification of vaginismus and female dyspareunia have been under scrutiny in the last few years. This case history adds knowledge, derived from clinical experience, to this fundamental debate. Methods. A female patient, successfully treated for primary vaginismus, was seen again for sexological therapy several years later. The opportunity to evaluate the initial therapeutic strategy and results inspired the authors to conduct an investigation into the individual variability of vaginismus patients needs. A review of historical debates on this topic is included. Recent research investigations from the Groningen University group (the role of disgust, and of moral standards) are included in the discussion. Results. Our uncommonly long case history reinforces our clinical conviction, which can be summarized as follows: patient needs are unique and diverse. We argue that this individual diversity seriously limits the power of controlled research. Conclusion. From a number of angles, there are striking differences between primary vaginismus and dyspareunia in clinical practice. Knowledge from clinical practice should be included into the conceptualization and classification discourse. Vaginismus and dyspareunia occupy problematic positions within sexological practice , first because they do not fit into the sexual response cycle and secondly, they cannot always be precisely distinguished from one another. Consequently, a debate 1 Our warmest appreciation for "Olivia", who chose her own alibi, allowed us to publish her history, and critically reviewed the manuscript. Also for Charmaine Borg, for helpful comments on an earlier draft of the manuscript, and for Astrid Pascal, for valuable comments on English language.

Healthy sexual function requires physical, mental, and emotional well-being. Physical presentations that may limit sexual activity include decreased mobility, alterations in sensation, decreased genital circulation and pain. Physical therapists play an important role in facilitating optimal sexual function by providing treatment to restore function, improve mobility and relieve pain. This article illustrates, through four case reports, the importance of physiotherapy in the multidisciplinary approach to the treatment of female sexual dysfunction.

Introduction.  The difficulty of penetration experienced in vaginismus and dyspareunia may at least partly be due to a disgust-induced defensive response.Aims.  To examine if sex stimuli specifically elicit: (i) automatic disgust-related memory associations; (ii) physiological disgust responsivity; and/or (iii) deliberate expression of disgust/threat.Methods.  Two single target Implicit Association Task (st-IAT) and electromyography (EMG) were conducted on three groups: vaginismus (N = 24), dyspareunia (N = 24), and control (N = 31) group.Main Outcome Measures.  st-IAT, to index their initial disgust-related associations and facial EMG for the m. levator labii and m. corrugator supercilii regions.Results.  Both clinical groups showed enhanced automatic sex-disgust associations. As a unique physiological expression of disgust, the levator activity was specifically enhanced for the vaginismus group, when exposed to a women-friendly SEX video clip. Also at the deliberate level, specifically the vaginismus group showed enhanced subjective disgust toward SEX pictures and the SEX clip, along with higher threat responses.Conclusions.  Supporting the view that disgust is involved in vaginismus and dyspareunia, for both, clinical groups’ sex stimuli automatically elicited associations with disgust. Particularly for the vaginismus group, these initial disgust associations persisted during subsequent validation processes and were also evident at the level of facial expression and self-report data. Findings are consistent with the notion that uncontrollable activated associations are involved in eliciting defensive reactions at the prospect of penetration seen in both conditions. Whereas deliberate attitudes, usually linked with the desire for having intercourse, possibly generate the distinction (e.g., severity) between these two conditions. Borg C, de Jong PJ, and Schultz WW. Vaginismus and dyspareunia: Automatic vs. deliberate disgust responsivity. J Sex Med 2010;7:2149–2157.

Disgust may be involved in sexual problems by disrupting sexual arousal and motivating avoidance of sexual intercourse. To test whether heightened disgust for sexual contaminants is related to sexual dysfunctions, the Sexual Disgust Questionnaire (SDQ) has recently been developed. Previous research showed that particularly women with vaginismus display a generally heightened dispositional disgust propensity and heightened disgust toward stimuli depicting sexual intercourse. To determine the psychometric properties of the SDQ and test whether heightened disgust toward sexual stimuli is specific to vaginismus or can be observed in other sexual dysfunctions as well. First, a large sample of undergraduates and university employees completed the SDQ (N = 762) and several trait disgust indices. Next, women with vaginismus (N = 39), dyspareunia (N = 45), and men with erectile disorder (N = 28) completed the SDQ and were compared to participants without sexual problems (N = 70). SDQ to index sexual disgust. The SDQ proved a valid and reliable index to establish disgust propensity for sexual stimuli. Supporting construct validity of the SDQ, sexual disgust correlated with established trait indices. Furthermore, sexual disgust and willingness to handle sexually contaminated stimuli were associated with sexual functioning in women, but not in men. Specifically women with vaginismus displayed heightened sexual disgust compared to women without sexual problems, while men with erectile disorders demonstrated a lower willingness to handle sexually contaminated stimuli compared to men without sexual problems. The SDQ appears a valid and reliable measure of sexual disgust. The pattern of SDQ-scores across males and females with and without sexual dysfunctions corroborates earlier research suggesting that disgust appraisals are involved especially in vaginismus and supports the view that the difficulty with vaginal penetration experienced by women in vaginismus may partly be due to disgust-induced defensive reflexes that could disrupt sexual arousal.

Vaginismus is currently defined as an involuntary vaginal muscle spasm interfering with sexual intercourse that is relatively easy to diagnose and treat. As a result, there has been a lack of research interest with very few well-controlled diagnostic, etiological or treatment outcome studies. 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. A review of the literature on the classification/diagnosis, etiology and treatment of vaginismus will be presented with a focus on the latest empirical findings. This article suggests that vaginismus cannot be easily differentiated from dyspareunia and should be treated from a multidisciplinary point of view.

Vaginismus is a female sexual pain disorder, characterized by contractions of the pubococcygeus (PC) muscle that surrounds the outer third of the vagina, which makes penetrative penile-vaginal intercourse (coitus), insertion of a finger or tampon and gynecological examinations hard or impossible, and painful for the woman. The condition is believed to be associated with negative beliefs, attitudes or experiences related to sex. Vaginismus has important social repercussions in everyday life, which acquire meaning in the context of hegemonic heterosexuality. In line with theories of performativity, heterosexuality and gender are normatively and performatively linked sets of practices, with coitus being the central practice of heterosexuality and thus defining for one's gender. Thus, the inability of vaginistic women to perform coitus impairs their performance of normative heterogender. In this article I address gender experiences of women with primary vaginismus, by looking at social and bodily practices they engage in. In the first part of the article, I explore how women with primary vaginismus do (vaginistic) heterogender. In the second part I address the practices they do in order to 'overcome' vaginismus, thus improving their performance of normative heterogender, and argue that these practices are gendering themselves.