Dyspareunia and vaginismus.

Dyspareunia and vaginismus are discussed to present information and a structural concept allowing the gynecologist to evaluate these conditions. The presence of subtle pelvic organic factors is frequently found in dyspareunic women referred for sex therapy by physicians. Thus a need for scrupulous evaluation, including laboratory work and other diagnostic tests, with close attention to the history of the patient is urged. In the remaining dyspareunic women and in those with vaginismus, a psychophysiologic conditioned response is present. Treatment approaches are discussed and the techniques of perineal muscle exercise and vaginal self-dilation are presented in detail. Used appropriately, these techniques produce a very high symptom elimination rate in these female sexual dysfunctions.