Culturally Sensitive Treatment Protocol for Vaginismus: A Case Study

Vaginismus is a common condition which involves a muscular contraction or spasm in the vagina prohibiting any type of penetration. Available evidence indicates that vaginismus appears more common in culturally conservative communities, though reliable prevalence rates are difficult to establish. Vaginismus presents as the inability to achieve penetration, or as the experience of severe pain upon penetration. In some cases, there is little muscular contraction and vaginal penetration is avoided primarily due to fear. Women with vaginismus often avoid gynecological exams, cannot insert a tampon, report feelings of sexual inadequacy and avoid any kind of sexual contact. This can have significant negative effects on their relationships or cause them to avoid relationships completely. The objective of this case study is to review a standard protocol of assessment, dilation, medication, psychotherapy and sex education in the treatment of vaginismus. We will then also review the combination of stigma, strict sexual values, and negative beliefs about sex in these cultures which may contribute to higher rates of the condition. We then report a case of primary vaginismus with associated pain that benefited from the treatment protocol. Treatment protocols which include some combination of dilation, medication, psychotherapy and sex education provide the most effective treatment for vaginismus.