Associate Professor

Vaginismus and pregnancy: our experience in Tunisia

Radhouane ACHOUR

Emergency Department of Obstetrics and Gynecology, Faculty of medicine of Tunis-El Manar University Tunis-Tunisia
Context
Vaginismus, a sexual dysfunction preventing any vaginal penetration, a priori, a symptom incompatible with pregnancy. However, there are women who are virgins and pregnant,
Vaginismus is a condition which is becoming increasingly rare, affecting up to 1% of the female population and which is characterized by an involuntary contraction of the perineal muscles resulting in the impossibility of penetration during sexual intercourse.
The Objective In this work, is to study the socio-demographic profile of these women / patients. The sexual life of the woman before conception, the desire for pregnancy (spontaneous or induced) and the circumstances of its incidence.
Methods – Patient(s) It is a prospective study about 20 pregnant patients diagnosed with vaginism carried out in the emergency department at the Neonatology and Maternity centre of Tunis (CMNT) from october 2016 to March 2017.
Vaginismus can lead to subfertility and affect a woman’s perception of her femininity and her potential for motherhood. Even so, women with vaginismus show a growing desire to have children. Many authors have described the syringe method (carotid insemination). However, reproductive medical assistance secondary to female subfertility was the method of achieving pregnancy for a large number of women with vaginismus.
Result (s) The mean age was 25.6 years. Vaginismus was classified as primary in 75% of cases. The rigid family environment or strict upbringing was the most common characteristic of our patients (70%). All the women studied (100%) reported the notion of pain during the first sexual intercourse. Sex is incomplete in 90% of cases. The repercussion on the couple was mainly represented by: a disruption of the couple’s relational life. 65% of patients had a spontaneous pregnancy due to incomplete intercourse, ejaculation at the entrance of the vagina without penetration. Vaginismus was an indication for caesarean section in 15 cases (75%).
Conclusions The primary reason for consulting women with vaginismus is the desire to become pregnant. Only 19% of women with sexual disorders would consult their gynecologist for this reason. it is a condition that can cause great physical and mental suffering.