VAGINISMUS AND INFERTILITY: WHY IMPOSE PENETRATIVE INTERCOURSE?

Probleme statement: sexual dysfunction could contribute up to 5% of couple infertility, association between infertility and vaginismus is well acknowledged.

Is it still legitimate to impose to couples penetrative intercourses to obtain pregnancy, especially when the woman`s body refuses vaginal sex? Is it still legitimate to represent vaginal penetration as normal and desirable, even when bodies say no? Couples can obtain sexual satisfaction in other ways and other practices. Must we move our Cultures towards sexual scripts respectful of differences? Is vaginal penetration really mandatory to obtain pregnancy or sexual pleasure?

Intravaginal insemination can be a simply, economical and fast procedure for conception in unconsummated union.

Method: literature review on Pubmed with the keywords: infertility and vaginismus, unconsummated marriage and pregnancy, infertility and sexual dysfunction

Result: vaginismus is always treated by attempts to normalize it in order to achieve penetrative vaginal sexuality. Treatments can be long and costly. In addition, the partner can himself present a sexual dysfunction such as an erectile dysfunction, and may prefer avoid penetrative sexuality and obtain sexual pleasure in another way.

Conclusion: should we ask ourselves about sexual scripts, sexual pleasure and desire for pregnancy? Is vaginal penetration still desirable to obtain sexual pleasure or pregnancy? Does the conventional treatment of vaginismus improve obstetrical issues? what it really means to force a vagina with vaginal dilators, pelvic exercises, psychotherapy. Must we change our point of view and dissociate sexual pleasure and pregnancy, propose sexual scripts adapted to people and simple and harmless solution to get pregnant. Should we build new representations, new desirable sexual scripts without the vaginal penetration`s duty? All couples are different and health care providers have to respect their sexual practices. Pregnancy and sexual pleasure are two different things: people may desire pregnancy and kids without the obligation of vaginal sex. We must say yes to new egalitarian sexual scripts, because sometimes the person with vagina does not want to be penetrated. Intravaginal insemination to obtain pregnancy is easy, costless and harmless compared to vaginismus therapies. We must no longer confuse vaginal penetration, couple sexual pleasure and desire of pregnancy.