Pregnancy is possible in patients with vaginismus. With proper treatment 100% of patients improve and achieve pregnancy spontaneously or with the help of assisted reproduction techniques.

What is vaginismus?

We define vaginismus as a female sexual dysfunction which consists of involuntary contraction of the muscles surrounding the vagina. It affects 12% of Spanish women, according to data from the Spanish society of General Medicine and conditions an inability for sexual intercourse. For this reason, if we do not make adequate treatment, pregnancy is not possible in patients with vaginismus.

We should not confuse the term of vaginismus with dyspareunia, which refers to pain during intercourse. Patients with dyspareunia achieve penetration (even though it is painful), while in vaginismus, penetration is not achieved.

Vaginismus types

Primary vaginismus: occurs in women who have never managed a vaginal penetration. When the patient starts having sexual intercourse or when she tries to insert a tampon into the vagina is discovered.

Secondary vaginismus: occurs in women who have had vaginal penetration before. On occasions it may be a sequel of a previous pregnancy and childbirth-related. 

Causes of vaginismus

There are multiple causes that can lead a patient to have vaginismus and we can include them into two groups:

Physical causes: they represent only 10% of the causes of vaginismus. The most common are endometriosis, tumors at the level of the pelvis, stenosis of vagina, pelvic inflammatory disease and more rarely, urethral caruncles and hemorrhoids, rigid hymen, or scars on the perineum.

Psychological causes: they occur in 90% of patients with vaginismus. They are multiple and often are related to having suffered sexual abuse, with fear of sexual intercourse or pregnancy, depression, low self-esteem and a limited and restrictive sex education issues.

Treatment of vaginismus

Vaginismus treatment should not be solely aimed at the achievement of pregnancy, and in this sense, it is very important to have a multidisciplinary approach in which we could involve gynecologists, psychologists and physiotherapists. The goal of the treatment should be getting the women to have sexual intercourse with penetration in a natural way and without being painful.

Virtually 100% of women with vaginismus get a clear improvement with proper treatment. For this, it is essential to have a specialized team and doctor-patient trust.

Assisted reproduction treatments to achieve pregnancy in patients with vaginismus

When the patient with vaginismus has sexual intercourse, but doesn´t become pregnant, or in more difficult cases in which penetration is infrequent, assisted reproduction treatments are an alternative for achieving a pregnancy.

The choice of an assisted reproduction treatment should not be conditioned by vaginismus, but based on the results of the fertility study of the couple. Any technique of reproduction whether artificial insemination, in vitro fertilization (IVF), egg donation or embryo donation can be adapted to the patient with vaginismus.

In almost all patients, with patience and gentleness, it is possible to perform transvaginal ultrasound for the control of the stimulation of the ovaries or the preparation of the endometrium. And, in those cases in which the severity of vaginismus makes it impossible, we can use the transrectal ultrasound, which offers an optimal visualization of the uterus and ovaries.

There are certain procedures, in all treatments, that can be done under sedation to facilitate the vaginal approach and decrease the possible pain. That would be the insemination in the artificial insemination, the follicular puncture in IVF or the embryo transfer in IVF, egg donation or embryo donation.  

In URH Garcia of Real we have extensive experience in the treatment of women with vaginismus that want to achieve pregnancy. Our personalized treatment and close relationship with our patients make them feel in an environment safe and close, something that is essential in this case. Our reproduction unit is also included within the Institute of Medicine EGR featuring, among others, specialists in physiotherapy and psychology. This allows to offer a multidisciplinary approach to all women with vaginismus.

 If you have vaginismus and are looking for a pregnancy, or if you are not looking for it but want to find a solution to this problem, you can make an appointment with us through our website or by calling 91 740 16 90. We offer you a free initial consultation to discuss your case and offer you the most appropriate treatment!

Dr. Laura Blasco Gastón – Gynecologist specialized in Assisted Reproduction