Welcome!

[Jennifer Dembo, LCSW]

Hi Everyone!

Welcome to our newest topic section! Yes, this is the vaginismus support forum, but we’re here for you no matter what your sexual health concern. Please let us know how we can be of help, especially if you are experiencing pain or discomfort that either hasn’t been diagnosed, or that you’re having trouble identifying on your own. We’re available for free 10-minute phone consults, and of course initial appointments once we’re onsite again.

Best wishes and good health to you all!

[nina]

I would like to know do I have a vaginismus, I have never had an intercourse, because I am afraid of the pain, I am anxious etc. when I was trying to put something inside it was so awfull feeling, maybe something like streching, for me it was like pain, I am afraid to repeat it… but I once have had a complete gyn examination, with her hand inside, pap smear and that small instrument – even if I was crying all the time and it was very uncomfortable, so she said that I do not have vaginismus….how to know is it vaginismus or something else…? sorry for my english…

[nina]

or is it dyspareunia?

[mazemelissa]

Hi Nina,

Welcome to the forum.

I do believe that you have some level of vaginismus. Vaginismus is defined as involuntary contraction of muscles around the opening of the vagina in women with no abnormalities in the genital organs. The tight muscle contraction makes sexual intercourse or any sexual activity that involves penetration painful or impossible.

There are different severities of vaginismus, so even though you were able to get through that gyn exam, it doesn’t rule out that you don’t have vaginismus. No woman should cry through a gyn exam.

The Lamont scale was developed to aide in the diagnosis of vaginismus. It allows a provider to:

Assess and score the severity of a patient’s reaction to a pelvic exam
Communicate with other healthcare providers the severity of the disorder
Better determine follow-up treatment options

KEY CLINICAL POINTS:
The provider attempts a pelvic exam: While Lamont categorized four degrees, a fifth degree was later added by Dr Pacik (the provider who pioneered the Botox procedure). The five degrees of severity are defined as follows:

First degree vaginismus results in a spasm of the pelvic floor. The patient can be reassured and can subsequently relax allowing the provider to complete the examination

Second degree vaginismus results in a generalized spasm of the pelvic floor as a steady state despite reassurance. Subsequently, the patient was unable to relax for the exam

Third degree vaginismus involves a pelvic floor spasm that is sufficiently severe that the patient elevates her buttocks in an attempt to avoid being examined

Fourth degree vaginismus, the most severe form of vaginismus described by Lamont, the patient would totally retreat by elevating the buttocks, moving away from the pelvic exam, and tightly closing the thighs to prevent any examination

Pacik described 5th degree vaginismus as a visceral reaction manifested by increased adrenalin output and resulting in any of the following: Increased heart rate, palpitations, hyperventilation, trembling, shaking, nausea or vomiting, crying uncontrollably, a feeling of light headedness and fainting, a desire to jump off the table, run away or even attack the provider.
(https://www.obgproject.com/2016/07/20/lamont-scale/)

Nina – I would classify you probably as a Level 2 or even 3 on this scale. It sounds like penetration causes you anxiety, and you are fearful to have another exam or any vaginal penetration. That is typical for patients with vaginismus.

As for dyspareunia….That is a term that just means painful intercourse. It is a broader term, and is often used as a catch all diagnosis. I tend to use dyspareaunia as a dx when a patient has deeper pain and not vaginal entrance pain.

I would encourage you to try a home dilation program and see how you fair slowly working with dilators.

Keep us updated!

Melissa