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Vaginismus(vaginismus; from the Latin. Vagina - vagina) - syndrome of convulsive contraction of the muscles of the vagina and pelvic floor, which occurs under the influence of mental. factors when trying to have sexual intercourse or make gynecological. study.
In some cases, there is also a spasm of the muscles of the thighs and abdominal wall. Sometimes there is a reflex bend of the trunk (lordosis in the lumbar and lower thoracic spine).
V. etiology is different. In the majority of women, V. arises with the onset of sexual activity due to the fear of pain during rupture (defloration) of the hymen. It may also develop as a result of a rude approach of a man to a woman, as well as in case of impotence (impotence) in a man, as a result of which sexual intercourse in a woman does not end in orgasm and a negative attitude to subsequent sexual intercourse appears. An important role in the occurrence of V. plays a psycho-neuropathic predisposition. V. is often observed with neurasthenia, obsessive-compulsive disorder, and hysteria. In the future, the syndrome manifests itself when trying to make a vaginal examination or to introduce k .-l.an instrument (for example, a gynecological mirror) in the vagina. False v. Occurs as a result of inflammation, external diseases. genitals and vagina, in the presence of eczema, cracks in the anus.
CLINIC. The leading symptom is muscle spasm of the vagina and pelvic floor. There are 3 degrees of B. severity. With the 1 st degree, a spasm occurs with the introduction into the vagina of the penis, instrument or fingers of the doctor during the study; with the 2nd - a similar reaction occurs when they are touched or close to the genitals; with the 3rd - the reaction occurs when only one thought about sexual intercourse or gynecological. research.
DIAGNOSIS is established on the basis of characteristic complaints and data of objective research. In B. even the first attempt at examination usually causes defensive reflexes with a typical clinic. picture.
TREATMENT V is performed by an obstetrician-gynecologist or sex therapist. It should be psychotherapeutic, include a detailed anamnesis and clarify the nature of psychogeny; explanatory conversation about V. the conviction of a woman in the absolute painlessness of treatment; gymnastics for the hips and abdominals; hypnotic suggestion - withdrawal of fear; expansion of a hole of a hymen and another At false V.- appropriate topical treatment, fortifying therapy. In rare cases, it is necessary to consult a neurologist, sometimes - a psychiatrist. It is advisable to send the husband of a suffering woman to a consultation with a urologist or a sex therapist.