188 Vaginismus (306.51)
DSM-IV-TR criteria
- A. Recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that interferes with sexual intercourse.
- B. The disturbance causes marked distress or interpersonal difficulty.
- C. The disturbance is not better accounted for by another Axis I disorder (e.g., Somatization Disorder) and is not due exclusively to the direct physiological effects of a general medical condition.
- Specify type:
- Lifelong Type
- Acquired Type
- Specify type:
- Generalized Type
- Situational Type
- Specify:
- Due to Psychological Factors
- Due to Combined Factors
Associated Features
- Vaginismus, or spasm of the muscle surrounding the vagina often occurs in response to attempted intercourse, but can also occur in response to penetration by a finger, tampon, or speculum. Although this disorder is listed as a pain disorder, pain is not a necessary condition for the diagnosis. Vaginismus may be best defined as a phobic/aversive response to vaginal penetration.
- There are two types of vaginismus: Primary and Secondary. Primary vaginismus occurs in women who have never been able to have pain-free intercourse. Secondary vaginismus is due to a medical condition, surgery, traumatic event, childbirth, or menopause.
- Individuals suffering from Vaginismus disorder display symptoms such as trouble or impossibilities with sexual penetration and pelvic examination.
Child vs. adult presentation
Vaginismus is a disorder that occurs in women. Children do not have to worry about it, although, Vaginismus could be linked to sexual trauma as a child, or teen.
Gender and cultural differences in presentation
- Vaginismus is only present in females.
- Research shows that 0.17% of women in the United Kingdom have this disorder. Also, 5 out of 1000 marriages in Ireland reported having this problem.
- The problem occurs in 1% to 6% of women and is highly comorbid with dyspareunia.
Epidemiology
- A study in 1993 by Rosen and colleagues estimate that the rates of vaginismus range from 5% to 17%.
- 2 out of 1000 women have this. However, it could be higher, because women are embarrassed and it is not commonly known about and often misdiagnosed.
- In the United States, 47% of women with this disorder are single or dating, while 53% are married.
- The majority (53%) are ages 26 to 35. Next, women aged 36-50 make up 26% of those with the disorder. 18% are 25 or younger and 9% are 51 or older.
Etiology
- Non-physical causes are fears, anxiety, stress, traumatic event, childhood experiences, and partner issues. Sometimes, there is no known cause at all. Physical causes are medical conditions, childbirth, abuse, menopause, pelvic trauma, and temporary discomfort.
- Most common causes are fears and anxiety about intercourse and pain. Anxiety due to performance pressures and negativity towards sex can also cause a woman to experience this. Partner issues such as abuse, distrust, and fear of commitment are causes as well.
Emp