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Vaginismus treatment with libido increase and practice
Abstract
Vaginismus is an involuntary contraction of the vaginal muscles which makes sexual intercourse difficult or impossible. It is one of the more common female psychosexual problems. The cases illustrate that it is important to rule out the possibility of vaginismus among patients with infertility. The aim of the report was to share with readers the cases with common presentations and underlying psychological causes.
... A number of researchers divide vaginismus into two general categories in terms of the time of occurrence: (1) primary or lifetime-in these cases, the woman has never experienced a painless and fearless intercourse, which is the most common reason for unconsummated marriage; and (2) secondary or acquired-in these cases, the woman experiences natural and painlessness intercourse and often gives birth to a child, but because of physical events, mental and psychological factors, infection or menopausal changes, she suffers from pain while attempting to have a sexual intercourse (Lahaie et al., 2010;Ramzy, 2018). Furthermore, vaginismus is classified as entire vaginismus, where intercourse is not possible, and partial vaginismus, wherein intercourse is possible but causes genital pain (Bahat et al., 2017). ...
Objectives: Evaluating the effect of botox injections on the satisfactory penetrating in women with vaginismus. Methods: A comprehensive systematic search in the electronic databases carried out up to September 2018. All studies that used botox to treat vaginismus were included in this review. Results: Nine cohort studies were included in meta-analysis. Our results indicate that botox can be an option for effective treatment of patients with vaginismus (event rate = 0.855, 95% confidence interval = 0.764 to 0.915; p-value < 0.001). Conclusion: Botox injection can improve vaginismus. However, because of the lack of randomized clinical trials, this conclusion should be carefully interpreted.
... It occurs during sexual intercourse and/or penetration with a swab or vaginal speculum during a gynecological examination. This involuntary contraction of the perineal muscles can aggravate or even make sexual life impossible [52]. ...
Botulinum toxins (BoNTs) are produced by several anaerobic species of the genus Clostridium and, although they were originally considered lethal toxins, today they find their usefulness in the treatment of a wide range of pathologies in various medical specialties. Botulinum neurotoxin has been identified in seven different isoforms (BoNT-A, BoNT-B, BoNT-C, BoNT-D, BoNT-E, BoNT-F, and BoNT-G). Neurotoxigenic Clostridia can produce more than 40 different BoNT subtypes and, recently, a new BoNT serotype (BoNT-X) has been reported in some studies. BoNT-X has not been shown to actually be an active neurotoxin despite its catalytically active LC, so it should be described as a putative eighth serotype. The mechanism of action of the serotypes is similar: they inhibit the release of acetylcholine from the nerve endings but their therapeutically potency varies. Botulinum toxin type A (BoNT-A) is the most studied serotype for therapeutic purposes. Regarding the gynecological pathology, a series of studies based on the efficiency of its use in the treatment of refractory myofascial pelvic pain, vaginism, dyspareunia, vulvodynia and overactive bladder or urinary incontinence have been reported. The current study is a review of the literature regarding the efficiency of BoNT-A in the gynecological pathology and on the long and short-term effects of its administration.
Background:
Vaginismus is involuntary vaginal muscle contraction which makes sexual intercourse difficult or impossible. It is one of the more common female psychosexual problems. Various therapeutic strategies for vaginismus, such as sex therapy and desensitization, have been considered in uncontrolled studies.
Objectives:
The aim of this review is to determine the clinical effectiveness of treatments for vaginismus and also to examine the role of partner participation in the effectiveness of the treatment.
Search strategy:
The Cochrane Collaboration Depression, Anxiety & Neurosis Controlled Trials Register (Issue 3, 2000), the Cochrane Controlled Trials Register (Cochrane Library, Issue 2, 2002), MEDLINE (1966 to Nov 2002), EMBASE (1980 to Nov 2002), PsycINFO (1967 to Nov 2002) and CINAHL (1982 to Nov 2002) were searched. The Journal of Sex Research (1974 to 1999), Sexual & Marital Therapy (1986 to 1999), Sexual Dysfunction (1998 to 1999) and the Journal of Sex and Marital Therapy (1974 to 1999) were handsearched. Reference lists and conference abstracts were searched. Experts in the field were contacted regarding unpublished material.
Selection criteria:
Controlled trials comparing treatments for vaginismus with another treatment, a placebo treatment, treatment as usual or waiting list control.
Data collection and analysis:
The reviewers extracted data which were verified with the trial investigator.
Main results:
Two controlled trials were identified although data were only available from one trial. The second trial compared two forms of systematic desensitization and reported no discernible differences between them.
Reviewer's conclusions:
In spite of encouraging results reported from uncontrolled series of patients there is very limited evidence from controlled trials concerning the effectiveness treatments for vaginismus. Further trials are need to compare therapies with waiting list control and with other therapies.
In light of various shortcomings of the traditional nosology of women's sexual disorders for both clinical practice and research, an international multi-disciplinary group has reviewed the evidence for traditional assumptions about women's sexual response. It is apparent that fullfilment of sexual desire is an uncommon reason/incentive for sexual activity for many women and, in fact, sexual desire is frequently experienced only after sexual stimuli have elicited subjective sexual arousal. The latter is often poorly correlated with genital vasocongestion. Complaints of lack of subjective arousal despite apparently normal genital vasocongestion are common. Based on the review of existing evidence-based research, many modifications to the definitions of women's sexual dysfunctions are recommended. There is a new definition of sexual interest/desire disorder, sexual arousal disorders are separated into genital and subjective subtypes and the recently recognized condition of persistent sexual arousal is included. The definition of dyspareunia reflects the possibility of the pain precluding intercourse. The anticipation and fear of pain characteristic of vaginismus is noted while the assumed muscular spasm is omitted given the lack of evidence. Finally, a recommendation is made that all diagnoses be accompanied by descriptors relating to associated contextual factors and to the degree of distress.
We present the British Association for Sexual Health and HIV (BASHH) Special Interest Group for Sexual Dysfunction recommendations for the management of vaginismus. The recommendations outline the history, prevalence, aetiological factors, patient assessment and management for this sexual problem. Treatment strategies are discussed along with general recommendations and auditable outcomes.
Assessment of 29 couples seeking marital therapy and 25 seeking sexual therapy at the same institution permitted the delineation of two distinct profiles. Although the two groups were similar in the degree of their sexual and marital difficulties and in demographic characteristics, the relationships of the sex therapy couples were generally characterized by satisfaction and affection, whereas those of the marital therapy couples were often antagonistic. In addition, the sex therapy couples tended to be less conservative and more thoughtful in their approach to life and their problems.
Dyspareunia, a symptom rather than a diagnosis, is defined as pain experienced by a woman during intercourse. This article discusses how to elicit an accurate sexual history and lists 12 common causes of dyspareunia. Three case reports from the authors' practices will be used to describe the diagnosis and treatment of women with vulvar vestibulitis, hymenal strands, and vaginismus.
The basic strategies and methods for assessing and treating vaginismus were proposed by the early 20th century and have not essentially changed. Etiological theories have changed over time but are not supported by controlled empirical studies. This critical review of the literature disputes the widely held belief that vaginismus is an easily diagnosed and easily treated sexual dysfunction. We propose a reconceptualization of vaginismus as either an aversion/phobia of vaginal penetration or a genital pain disorder.
Pharmacotherapy in pregnancy is often problematic, since both the mother-to-be and her doctor are often concerned about possible risks for the unborn child. On the other hand, we now have sufficient knowledge of a whole range of medications, to enable the recommendation of safe drug treatment in almost any clinical situation. The family doctor, too, is often consulted by pregnant women requiring treatment for internistic problems. These include such pregnancy-unrelated problems as essential hypertension or bronchial asthma, as well as pregnancy-related disorders such as urinary tract infection or gastrointestinal problems.
ISSM (International Society of Sexual Medicine) Standard committee book, standard practice in sexual medicine
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