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Vaginismus and pregnancy: epidemiological profile and management difficulties

Authors Achour R, Koch M, Zgueb Y, Ouali U, Ben Hmid R

Received 9 September 2018

Accepted for publication 5 February 2019

Published 12 March 2019 Volume 2019:12 Pages 137—143

DOI https://doi.org/10.2147/PRBM.S186950

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Cristina Weinberg

Peer reviewer comments 3

Editor who approved publication: Professor Igor Elman


Radhouane Achour,1 Marianne Koch,2 Yosra Zgueb,3 Uta Ouali,3 Rim Ben Hmid1

1Emergency Department of Gynecology and Obstetrics, Maternity and Neonatology Center of Tunis, Faculty of Medicine of Tunis, El Manar University of Tunis, Tunis, Tunisia; 2Department of Obstetrics and Gynecology, Medical University of Vienna Austria; 3Psychiatry Department, Razi Hospital, Faculty of Medicine of Tunis, El Manar University of Tunis, Tunis, Tunisia

Background: Vaginismus affects up to 1% of the female population and often represents a physical manifestation of an underlying psychological problem. Our objective was to investigate the psychosomatic impact of vaginismus in pregnant women and evaluate the quality of their therapeutic care in Tunisia.
Methods: We included pregnant patients with vaginismus who presented at our obstetric emergency department between October 2016 and March 2017. All patients were interviewed by one expert psychiatrist and gynecologist using a standardized questionnaire. The State-Trait Anxiety Inventory (STAI) was used to determine anxiety and depression levels. Patients were prospectively followed until their postpartum period and were interviewed by the same experts after delivery. Sixteen weeks after hospital discharge, we contacted all patients via phone. All the information was simultaneously recorded in written form.
Results: Twenty pregnant patients with vaginismus were included (85% primary, 15% secondary). Most women described a conservative family background (70%) in which they received little or no sexual education (60%). All women described a feeling of anxiety and anger immediately before sexual intercourse and 40% have never sought medical consultation regarding their vaginismus before. Only 50% reported regular follow-up visits during their pregnancy (without vaginal examination), whereas 25% reported irregular follow-up visits with subjectively bad experiences during attempts of vaginal examinations.
Conclusion: Pregnant women with vaginismus are at risk of non-follow-up during their pregnancy due to underlying feelings of shame and experienced lack of understanding by medical staff. Obstetricians should carefully and attentively approach pregnant women with vaginismus in order to ensure adequate medical care during pregnancy.

Keywords: vaginismus, pregnancy, profile, impact
 

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