Treatment of vaginismus

a. Vaginal dilators. Plastic syringe covers or vaginal dilators are available in sets of 4 graduated sizes. The smallest dilator (the size of the fifth finger) is placed in the vagina by the woman. As each dilator is replaced with the next larger size without pain, muscle relaxation occurs. b. Muscle awareness exercises

(1) The examiner places one finger inside the vaginal introitus, and the woman is instructed to contract the muscle that she uses to stop urine flow. The woman then inserts her own finger into the vagina and contracts. The process is continued at home.

(2) Once a woman can identify the appropriate muscles, vaginal contractions can be done without placing a finger in the vagina.

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