Primary<unk> <unk>  occurs when penetrative sex or other vaginal penetration cannot be experienced without pain. It is commonly discovered among teenage girls and women in their early twenties, as this is when many girls and young women first attempt to use tampons, have penetrative sex, or undergo a Pap smear. Awareness of<unk>  may not happen until vaginal penetration is attempted. Reasons for the condition may be unknown. A few of the main factors that may contribute to primary<unk>  include: * chronic pain conditions and harm-avoidance behaviour * negative emotional reaction towards sexual stimulation, e.g. disgust both at a deliberate level and also at a more implicit level * strict conservative moral education, which also can elicit negative emotions Primary<unk>  is often unknown cause.<unk>  has been classified by Lamont according to the severity of the condition. Lamont describes four degrees of<unk> : In first degree<unk> , the person has spasm of the pelvic floor that can be relieved with reassurance. In second degree, the spasm is present but maintained throughout the pelvis even with reassurance. In third degree, the person elevates the buttocks to avoid being examined. In fourth degree<unk>  (also known as grade 4<unk> , the most severe form of<unk> , the person elevates the buttocks, retreats and tightly closes the thighs to avoid examination. Pacik expanded the Lamont classification to include a fifth degree in which the person experiences a visceral reaction such as sweating, hyperventilation, palpitations, trembling, shaking, nausea, vomiting, losing consciousness, wanting to jump off the table, or attacking the doctor. Although the pubococcygeus muscle is commonly thought to be the primary muscle involved in<unk> , Pacik identified two additionally-involved spastic muscles in people who were treated under sedation. These include the entry muscle (bulbocavernosum) and the mid-vaginal muscle (puborectalis). Spasm of the entry muscle accounts for the common complaint that people often report when trying to have intercourse: "It's like hitting a brick wall". Secondary<unk>  Secondary<unk>  occurs when a person who has previously been able to achieve penetration develops<unk> . This may be due to physical causes such as a yeast infection or trauma during childbirth, while in some cases it may be due to psychological causes, or to a combination of causes. The treatment for secondary<unk>  is the same as for primary<unk> , although, in these cases, previous experience with successful penetration can assist in a more rapid resolution of the condition. Peri-menopausal and menopausal<unk> , often due to a drying of the vulvar and vaginal tissues as a result of reduced estrogen, may occur as a result of "micro-tears" first causing sexual pain then leading to<unk> .
Vaginismus
Dyspareunia
Anismus
Geniospasm
Trismus
Facial weakness
Carotidynia
Paronychia