Obstetrics & Gynecology>>>>>Human Sexuality and Contraception
Question 15#

A 22-year-old nulliparous woman has recently become sexually active. She consults you because of painful intercourse. She says her pain occurs with insertion, and is accompanied by cramping of her pelvic muscles. She says it is so painful that she does not want to have intercourse with her boyfriend, which is causing problems in their relationship. Other than confirmation of these findings, the pelvic examination is normal.

Which of the following is the most common cause of this condition?

A. Endometriosis
B. Psychogenic causes
C. Bartholin gland abscess
D. Vulvar atrophy
E. Ovarian cyst

Correct Answer is B

Comment:

Vaginismus is both an emotional and pain disorder. It involves involuntary painful spasm of the pelvic muscles and vaginal outlet that precludes intercourse, and causes stress or interpersonal difficulty. The patient is averse to vaginal penetration due to anticipated or actual pain. It usually has a large psychogenic component. It is different from dyspareunia, which is defined as genital pain associated with sexual activity that is not caused by a problem with lubrication or vaginismus. Treatment of vaginismus is primarily a combination of cognitive and behavioral therapy