Effect of Multimodal Physical Therapy on Vaginismus Secondary to Chronic Constipation

The purpose of this study is to investigate the effect of multimodal physical therapy on vaginismus secondary to chronic constipation

Inclusion Criteria: * Newly married females, with regular menstrual periods, have an inability to allow vaginal penetration and failed vaginal intercourse (primary vaginismus). * They complain of chronic constipation in the form of functional obstruction due to dysfunction of pelvic floor muscle and anal sphincter (anismus), leading to difficulties in expel stool from the anorectum. * Their age ranges from 25 - 35 years old. * Their body mass index ranges from 20 - 25 Kg/m2. Exclusion Criteria: * Congenital uterine anomalies. * Pelvic or abdominal surgeries * Circumcision. * Intrinsic pelvic pathology including endometriosis, acute or chronic pelvic inflammatory disease, cervicitis, benign or malignant gynecologic tumors or uterine pathology including adenomyosis or leiomyoma and postoperative adhesions, in addition to any form of infection including herpes virus * Lesions such anorectal ulcers, inflammation or malignancy. * Irregular or infrequent menstrual cycles. * Heavy menstrual bleeding (HMB). * Systemic diseases.