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Diagnosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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diagnosis

Differentiating superficial dyspareunia and vaginismus from clinical presentation is a challenging task.

A carefully constructed medical and psycho-sexual history is necessary to make a diagnosis of vaginismus.

  • some of the questions which can be enquired from the patient include:
    • is she in a relationship?
    • is she sexually active with her partner?
    • is penetration possible? if so, is it painful?
    • is it painful only at penetration?
    • how anxious does she feel at the thought of penetration?
    • can she insert tampons or fingers?
    • how long has this been a problem?
    • how anxious does she feel about the thought of a genital examination?
    • has she ever had a traumatic sexual experience?
  • obtain a clear description of the pain, fear, and avoidance responses
  • for psychological assessment find out about sexual knowledge and family attitudes to sexual behaviour
  • find out about the ability to tolerate genital exploration by herself or another
  • exclude other causes for sexual pain e.g. - herpes virus, lichen sclerosis, vulvodynia etc

Genital examination may be necessary to exclude organic pathology (1).

Reference:

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