title: Vaginal spasm, pain, and behavior: an empirical investigation of the diagnosis of vaginismus.
abstract: This study investigated the roles of vaginal spasm, pain, and behavior in vaginismus and the ability of psychologists, gynecologists, and physical therapists to agree on a diagnosis of vaginismus. Eighty-seven women, matched on age, relationship status, and parity, were assigned to one of three groups: vaginismus, dyspareunia resulting from vulvar vestibulitis syndrome (VVS), and no pain with intercourse. Diagnostic agreement was poor for vaginismus; vaginal spasm and pain measures did not differentiate between women in the vaginismus and dyspareunia/VVS groups; however, women in the vaginismus group demonstrated significantly higher vaginal/pelvic muscle tone and lower muscle strength. Women in the vaginismus group also displayed a significantly higher frequency of defensive/avoidant distress behaviors during pelvic examinations and recalled past attempts at intercourse with more affective distress. These data suggest that the spasm-based definition of vaginismus is not adequate as a diagnostic marker for vaginismus. Pain and fear of pain, pelvic floor dysfunction, and behavioral avoidance need to be included in a multidimensional reconceptualization of vaginismus.
authors.affiliation: School of Psychology, University of Ottawa, Ottawa, Ontario, Canada. reissing@uottawa.ca
authors.forename: Elke D
authors.initials: ED
authors.lastname: Reissing
authors.forename: Yitzchak M
authors.initials: YM
authors.lastname: Binik
authors.forename: Samir
authors.initials: S
authors.lastname: Khalifé
authors.forename: Deborah
authors.initials: D
authors.lastname: Cohen
authors.forename: Rhonda
authors.initials: R
authors.lastname: Amsel
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003075:Coitus / Q000523:psychology; D004414:Dyspareunia / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000209:etiology* / Q000523:psychology; D011792:Quebec; D012649:Self Concept; D012720:Severity of Illness Index; D012736:Sex Education; D020018:Sexual Dysfunctions, Psychological / Q000150:complications / Q000175:diagnosis*; D012917:Social Adjustment; D011795:Surveys and Questionnaires; D014848:Vulvovaginitis / Q000150:complications / Q000175:diagnosis*; D016387:Women's Health