ABSTRACT
Non-consummation of a relationship often presents late with embedded behaviours that may take time to resolve. Vaginismus may have always been present and contribute to unsuccessful sexual relationships or develop after a traumatic experience, recognised or unrecognised. Referral from primary care to the psychosexual clinic or gynaecology clinic depends on the general practitioner or practice nurse's perception of the causes of the non-consummation or vaginismus. One young woman presented to a gynaecology clinic with vaginismus associated with a history of frequent examinations by gynaecologists as a child, when she was found to have an ‘interesting’ combination of uterine and vaginal anomalies that required several operations. Skin and mucosal conditions are frequently associated with dyspareunia and therefore secondary vaginismus. There are many chronic pain conditions that will cause a secondary protective response which can result in vaginismus. A psychological response may logically be protection from sexual activity by loss of libido and/or sexual pain due to vaginismus.
