A Proposal for Psycho Physiologic Classification on Vaginismus
On vaginismus, which occupies more than 60% of the patients of FSD in the author’s sex therapy, psycho physiologic classification according to the first gynecological finding is proposed.
Method: Among the vaginismus patients of 1987 to 2011, 121 that gave suitable finding were categorized to 5 types. The type 1 to 3 indicates the spasm or contraction of vagina, namely shows strong, middle and none spasm. Type 4 is the patient who couldn’t accept vaginal examination at all, and Type 5 shows no abnormal finding despite the fact that they couldn’t have sexual intercourse.
Results: The ratio of those 1 to 5 types of vaginismus patients is 27.3, 36.4, 20.7, 11.6 and 4.1% in that order. The level of phobia that patients expressed at the examination was high in Type 3 and low or none in Type 1 patients. There were no differences in outcome of sex therapy among those groups except that the result of Type 4 was less than others. Patients of Type 4 demonstrated hypersensitivity or pain on vulva, and or strong fear for penetration.
Consideration: Vaginismus is a variety of psychophysiology consisted of fear and somatic reaction to vaginal penetration. The proposed classification is helpful to understand the psycho physiologic status of vaginismus patients. The Type 1 in this classification could be Vaginismus or Psychosomatic type, and Type 3 could be Phobia type as well. The author considers adding “hypersensitivity on vulva” to “vaginal spasm” as a somatic expression of the refusal of penetration.
