Vagina: Persistent and recurrent problems of women to allow vaginal penetration of the penis, the finger and / or any object, despite its wish to do so.

Often avoidance (phobic) is related to the anticipation or fear of the experience of pain that is associated with involuntary contractions of the muscles surrounding the vagina. vaginismus can be:

• Primary is excluded the possibility of any form of penetration. The woman is a virgin.
• Secondary: refers to those women who, after a period of time without problems begin to manifest the difficulty / inability to have a penetration

The classification of the vagina is made on the basis of some basic parameters:

1. Intensity of muscle spasm
2. Phobia severity (mild, medium or severe);
3. Presence and severity of psychosexual factors, personal or torque, contributing to the genesis and / or maintenance of the symptom.

In cases in which the vagina is not so severe as to prevent the penetration, the ratio is possible but causes pain: this is called dyspareunia.

CAUSES

Organic factors:
• Congenital malformations of the vagina or the hymen
• Vulare pain syndrome (vulvodynia)
• Pelvic floor myalgia
• Trophic mucosal

Psychosexual factors: sexuality and intimacy of sexual intercourse may be associated with stimuli and negative thoughts that originate in:
• Poor sex education
• Taboo
• Negative sexual experiences
• Fear of pain
• Rape
• Unwanted pregnancy
• Need to maintain control
• Perception of risk in allowing another person

Factors pair: very often the partner of the woman vaginismica shares a fear about the penetration, so that many authors speak of "symmetry secret. You may temporarily experience:
• Inexperience or lack of sexual experience of partner
• Presence of sexual disorder in your partner (premature ejaculation, erectile dysfunction)
• Deep emotional intimacy but not sexual
• Not released by the family of origin

TREATMENT
The treatment of choice sees the couple involved, not the individual women with the symptom. Treatment strategies start by attention to the perceived immediate causes: muscle spasm that prevents the relationship and the fear of pain.

The first phase of information on anatomy and physiology of male and female genitalia and sexual intercourse following the presentation of behavioral techniques focused to a progressive vaginal dilatation. Sexual intercourse is the ultimate goal of treatment that will be when the woman feels that he has acquired a certain mastery and awareness of his genitals.

Fundamental work with the couple intended to deepen the psychological problems associated with sexuality, specific aspects of the relationship, negative influences.
Key moment of the processing and transmission for gynecological consultation.