Connections between primary vaginismus and procreation: some observations from clinical practice

So far, the literature on vaginismus has mainly been contemplative. Quantitative data are scarce, while fertility and obstetrical aspects are almost never considered. In this article, these two aspects are addressed. A cohort of patients received a questionnaire, developed to obtain information about possible connections between the vaginistic reaction, the patient's treatment goals and, if relevant, obstetrical characteristics. Our data reveal that the desire to have a child is not a negative predictor for treatment outcome in terms of consummation. In some instances, however, self-insemination, as a bedroom procedure, is an effective treatment option to enable the couple to reach their fertility goal. Some women will conceive without intercourse experience; according to our data, delivery in this group is hardly more problematic than in a group of women who, after treatment for vaginismus, conceived by sexual intercourse. Having delivered a child may have a slightly positive effect on the capability to have intercourse, but only in a minority. Obstetricians should be aware that not infrequently, women give birth who suffer from severe penetration phobias.