Learning Objectives and CME/Disclosure Information
This activity is intended for healthcare providers delivering care to women and their families.
After completing this activity, the participant should be better able to:
1. Define vaginismus 2. Recall the underlying mechanism that causes vaginismus
Estimated time to complete activity: 0.25 hours
Susan J. Gross, MD, FRCSC, FACOG, FACMG President and CEO, The ObG Project
Disclosure of Conflicts of Interest
Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.
Faculty: Susan J. Gross, MD, receives consulting fees from Cradle Genomics, and has financial interest in The ObG Project, Inc.
Planners and Managers: The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose.
Method of Participation and Request for Credit
Fees for participating and receiving CME credit for this activity are as posted on The ObG Project website. During the period from Dec 31 2017 through Dec 31 2021, participants must read the learning objectives and faculty disclosures and study the educational activity.
If you wish to receive acknowledgment for completing this activity, please complete the post-test and evaluation. Upon registering and successfully completing the post-test with a score of 100% and the activity evaluation, your certificate will be made available immediately.
For Pharmacists: Upon successfully completing the post-test with a score of 100% and the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
Joint Accreditation Statement
In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and The ObG Project. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Medical Education
Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Continuing Nursing Education
The maximum number of hours awarded for this Continuing Nursing Education activity is 0.2 contact hours.
Vaginismus is a condition where there is both an involuntary tightening of the vagina during any type of attempted penetration and a concurrent fear regarding pain during penetration.
In some cases, tightness may begin to cause burning, pain, or stinging during intercourse. In other cases, penetration may be difficult or completely impossible
Vaginismus is the main cause of unconsummated relationships due to painful intercourse
It is believed that 6-12% of women have vaginismus. However, gathering reliable statistics for vaginismus is hindered by many factors, and the actual number may be quite higher
Secondary vaginismus is a similar, though far less severe condition which woman may experience after having a history of pain free penetration and intercourse. While it is characterized by similar tightening of the muscles it is generally associated with little to no fear of penetration
KEY CLINICAL POINTS:
Vaginal tightness is actually caused by involuntary contractions of the pelvic floor muscles surrounding the vagina. Often a woman is not aware that the muscle response is causing the tightness or penetration problem.
In nearly every case the muscle tightness sets off a cycle of pain and fear which compounds itself. That is, the condition lives on a continuum of fear and pain. For some women the muscles are extremely tight and there is not a great deal of fear and for some women the muscles are only mildly tight but the woman is extremely fearful.
The tightness can be so restrictive that the opening to the vagina is ”closed off’ altogether and the man is unable to insert his penis. The pain of vaginismus ends when the sexual attempt stops, and usually intercourse must be halted due to pain or discomfort.
In its mildest form, a woman can get a penis into the vagina for very short periods, but it is unpleasant and painful. Or it can be so severe that she cannot even touch herself near her vagina, cannot have a gynecological exam and can’t insert a tampon because the pain is so severe and the fear so great.
Women with severe vaginismus will often describe the feeling as the penis “hitting a wall” when they attempt intercourse. Vaginismus can be devastating and debilitating, not because the absence of intercourse means the patient can’t have a satisfying sex life, but because of psychological impact it can have on women, often making them feel as though there is something abnormal about them.
While women in lesbian relationships are less impacted by vaginismus, they too struggle with this condition, making them unable to insert tampons, have normal gynecological exams and often they too feel isolated from mainstream society in what they perceive to be their “abnormality.”
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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