How to receive a diagnosis of vaginismus without the exam?

[Heather34]

Hi all. In a recent 2016 article, a patient describes how she was misdiagnosed with vulvodynia when she, in fact, had vaginismus. She went on to be treated successfully at Maze Women’s Sexual Health. For someone who has the symptoms of vaginismus but is too afraid of gynecology exams or for whom an exam is impossible (i.e. extreme anxiety, inability of the speculum to go in due to extreme burning pain, etc.), how is vaginismus diagnosed?

[Aimee Goldman, RWHNP]

When a patient has vaginismus a gynecologic exam can be impossible due to fear and pain.
Here at Maze we are very sensitive to this. Many of our patients are diagnosed with Vaginismus based on history alone. These patients describe a history where they are unable to insert a tampon. Many have gone to see a gynecologist where a pelvic exam and pap smear where unable to be preformed. Some have attempted intercourse but were unable to do so due to pain , fear and anxiety.
At Maze, we do a lot of listening before an actual exam is done. We asses the patients ability to have a gynecologic exam based on history that the patient provides us.
Fear of a gynecology exam should not prevent a woman from seeking help with vaginismus.

[Heather34]

Hi Aimeee. This is a wonderful post. One of the great fears that I had and so many others who I’ve talked to shared is how to receive any form of treatment when an exam is impossible. I was terrified of this prior to my own Botox procedure and expressed this to Dr. P and it wasn’t done until under anesthesia. Post-Botox, I was able to undergo all of the exams pain-free. For anyone reading this who shares this fear, please read and re-read this post.