A review of Vaginismus Treatments

Document Type : Review Article

Authors

1 M.Sc. in Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 Professor, Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Science, Tehran, Iran.

Abstract

Introduction: Vaginismus is an involuntary contraction of the vaginal muscles that makes sexual intercourse difficult or impossible. Various treatment strategies have been proposed for vaginismus, such as sex therapy and desensitization. There is no sufficient evidence on the efficacy and effectiveness of vaginismus interventions. This review study was performed with aim to evaluate the effects of different interventions for vaginismus.
Methods: In this review study, to find the related articles, the databases of SID, Pubmed, Google scholar, and Science direct were searched using the key words of vaginismus, treatment, and clinical trial from 2002 to 2020. Criteria for selecting a controlled clinical trial were comparison of vaginismus treatments with other treatments, placebo treatment, and routine treatment, or waiting list for treatment.
Results: In this study, 15 studies with a total of 655 participants were reviewed. The results of this study showed that cognitive-behavioral therapies, the use of dilators, Botox, sex therapists, and hypnotherapy could successfully treat vaginismus. Regarding the effectiveness of strategies, Cognitive Behavioral Therapy (CBT) with the highest number of trials has been very successful. After that, the use of dilators was very popular.
Conclusion: This study showed that Cognitive Behavioral Therapy (CBT), the use of vaginal dilators, hypnotherapy, Botox and physiotherapy led to successful and satisfactory intercourse.

Keywords


  1. Pacik Understanding and treating vaginismus: a multimodal approach. International urogynecology journal 2014; 25(12):1613-20.
  2. Маршанія З. Certain socio-cultural aspects of prevalence and treatment of vaginismus in Georgia. Health of Man 2017; 1(60):71-3.
  3. Maseroli E, Scavello I, Rastrelli G, Limoncin E, Cipriani S, Corona G, et al. Outcome of medical and psychosexual interventions for vaginismus: a systematic review and meta-analysis. The journal of sexual medicine 2018; 15(12):1752-64.
  4. Ventegodt Sex and the quality of life in Denmark. Archives of sexual behavior 1998; 27(3):295-307.
  5. Sh S, Keramat A, Malary M, Rezaie Chamani S. A Systematic Review of Vaginismus Prevalence Reports. J Ardabil Uni Med Sci 2019; 19(3):263-71.
  6. Lahaie MA, Boyer SC, Amsel R, Khalifé S, Binik YM. Vaginismus: a review of the literature on the classification/diagnosis, etiology and treatment. Women’s Health 2010; 6(5):705-19.
  7. Reissing ED, Binik YM, Khalifé S. Does vaginismus exist?: A critical review of the literature. The Journal of nervous and mental disease 1999; 187(5):261-74.
  8. Fadul R, Garcia R, Zapata-Boluda R, Aranda-Pastor C, Brotto L, Parron-Carreño T, et al. Psychosocial correlates of vaginismus diagnosis: A case-control study. Journal of sex & marital therapy 2019; 45(1):73-83.
  9. Hamidi S, Shareh H, Hojjat SK. Comparison of early maladaptive schemas and attachment styles in women with vaginismus and normal women. Iran J Obstet Gynecol Infertil 2015; 18(155):9-18.
  10. Marthasari RS, Marlinata A, I’tishom R. Vaginismus and Infertility. Indonesian Andrology and Biomedical Journal 2020; 1(2):48-53.
  11. Velayati A, Jahanian Sadatmahalleh S, Ziaei S, Kazemnejad A. Can botox offer help women with vaginismus? A systematic review and meta-analysis. International Journal of Sexual Health 2019; 31(3):233-43.
  12. Engman M, Wijma K, Wijma B. Long-term coital behaviour in women treated with cognitive behaviour therapy for superficial coital pain and vaginismus. Cognitive behaviour therapy 2010; 39(3):193-202.
  13. ter Kuile MM, van Lankveld JJ, de Groot E, Melles R, Neffs J, Zandbergen M. Cognitive-behavioral therapy for women with lifelong vaginismus: Process and prognostic factors. Behaviour ReSearch and therapy 2007; 45(2):359-73.
  14. Seo JT, Choe JH, Lee WS, Kim KH. Efficacy of functional electrical stimulation-biofeedback with sexual cognitive-behavioral therapy as treatment of vaginismus. Urology 2005; 66(1):77-81.
  15. Yaraghi M, Ghazizadeh S, Mohammadi F, Ashtiani EM, Bakhtiyari M, Mareshi SM, et al. Comparing the effectiveness of functional electrical stimulation via sexual cognitive/behavioral therapy of pelvic floor muscles versus local injection of botulinum toxin on the sexual functioning of patients with primary vaginismus: a randomized clinical trial. International urogynecology journal 2019; 30(11):1821-8.
  16. Ter Kuile MM, Melles R, de Groot HE, Tuijnman-Raasveld CC, van Lankveld JJ. Therapist-aided exposure for women with lifelong vaginismus: a randomized waiting-list control trial of efficacy. Journal of consulting and clinical psychology 2013; 81(6):1127.
  17. Aslan M, Yavuzkır Ş, Baykara S. Is “Dilator Use” More Effective Than “Finger Use” in Exposure Therapy in Vaginismus Treatment?. Journal of sex & marital therapy 2020; 46(4):354-60.
  18. Baktriya F, Rafieinia P, Sabahi P, Nazari L. The Effect of Hypnotherapy on Sexual Function, Pain Catastrophizing and Irrational Beliefs about Fear of Sex in Women with Vaginismus (Genito-Pelvic Pain/Penetration Disorder). Journal of Urmia Nursing and Midwifery Faculty 2020; 17(124):907-18.
  19. Pourhosein R, Ehsan ZB. Using hypnosis in a case of vaginismus: a case report. Procedia-Social and Behavioral Sciences 2011; 15:3886-9.
  20. Al-Sughayir MA. Vaginismus treatment. Hypnotherapy versus behavior therapy. Neurosciences Journal 2005; 10(2):163-7.
  21. Elsheikh Botox injection for treatment of refractory vaginismus in Egyptian Women. Life Science Journal 2018; 15(1):45-50.
  22. Pacik Onabotulinumtoxin A as part of a multimodal program to treat vaginismus. Journal of Applied Biobehavioral Research 2015; 20(1):25-36.
  23. Bertolasi L, Frasson E, Cappelletti JY, Vicentini S, Bordignon M, Graziottin A. Botulinum neurotoxin type A injections for vaginismus secondary to vulvar vestibulitis syndrome. Obstetrics & Gynecology 2009; 114(5):1008-16.
  24. Ghazizadeh S, Nikzad M. Botulinum toxin in the treatment of refractory vaginismus. Obstetrics & gynecology 2004; 104(5):922-5.
  25. de Abreu Pereira CM, Ambrosio RT, Borges EM, Lima SM, dos Santos Alves VL. Physiotherapy protocol with interferential current in the treatment of vaginismus-Observational and prospective study. Manual Therapy, Posturology & Rehabilitation Journal 2019: 1-5.
  26. Praharaj SK, Verma P, Arora M. Topical lignocaine for vaginismus: a case report. International journal of impotence research 2006; 18(6):568-9.
  27. Anğın AD, Gün İ, Sakin Ö, Çıkman MS, Eserdağ S, Anğın P. Effects of predisposing factors on the success and treatment period in vaginismus. JBRA assisted reproduction 2020; 24(2):180-8.