2/2007Vaginismus: A clinical entity in primary care

ERSIN AKPINAR, ESRA SAATCI (Cukurova University Faculty of Medicine, Department of Family Medicine,Adana, Turkey)

Summary
The pain problem in sexual disorders including dyspareunia and vaginismus has led to a focus on psychogenic and interpersonal issues after biological causes were excluded in practice and research. Pain and fear of pain, pelvic floor dysfunction, and behavioural avoidance need to be included in a multidimensional reconceptualization of vaginismus. This new concept focuses on the central phenomenon – pain. It also suggests new therapeutic approaches. Primary care physicians should have a proactive role in the diagnosis and treatment of these disorders. Vaginismus affects, both physically and emotionally, female adolescents and women indiscriminately, regardless of culture, religion, and profession. Vaginismus may manifest itself as mild, with some anxiety, or as severe, with devastating panic attacks. The etiology is complex and varied and requires clinical competency. Successful intervention should be rendered through the body and the mind to ensure a complete solution. A team work with the leading family physician is required for the success in the management of the condition.

Key words: vaginismus, primary care, sexual pain disorder