title: Couple characteristics and outcome of therapy in vaginismus.
abstract: OBJECTIVE
  To describe couple characteristics and outcome of therapy in vaginismus.
  
  
  METHODS
  A prospective before-after intervention descriptive study.
  
  
  METHODS
  Department of Physiology, Faculty of Medicine, Colombo, Sri Lanka.
  
  
  METHODS
  Fifty six couples with vaginismus, mostly self referrals and referrals from gynaecologists and general practitioners, were treated with a standard cognitive behaviour therapy protocol with before-after assessments of the degree of vaginismus and individual partner self-ratings of the relationship and psychological status (GHQ-30).
  
  
  METHODS
  Success at the end of the therapy was equated to the absence of or only mild vaginismus and, improvement in the couple relationship and psychological status scores.
  
  
  RESULTS
  Twenty seven (48%) of the 52 (93%) couples with non-consummation reported failure of coitus following previous non-surgical and surgical interventions. Love marriages (70%), frequent attempts at sex (75%, 3 or 4 times/week) and sexual arousal (women = 86%, men = 89%) characterised couples. Ten men developed sexual problems, mostly erectile failure and premature ejaculation secondarily. Couple therapy enabled penetrative sex in 45 (80.3%). The single prognostic indicator of outcome was the degree of vaginismus at first visit, those with mild and moderate vaginismus (77%) being significantly more likely to establish coitus (p<0.001) and complete the therapy (p<0.001). The couple relationship improved marginally (women p<0.01, men 0.025<p>0.01) but the psychological status remained unchanged. Dropouts and referrals for psychiatric and marital counselling failed to complete therapy.
  
  
  CONCLUSIONS
  Couple sex therapy is effective in the management of vaginismus. Health professionals, especially gynaecologists and general practitioners, need to be aware of the problem and the satisfactory outcome of sex therapy.
authors.affiliation: Medical Officer, The Central STD Clinic, National STD/AIDS Control Programme, Colombo. tmunasinghe@hotmail.com
authors.forename: Thiloma
authors.initials: T
authors.lastname: Munasinghe
authors.forename: Colvin
authors.initials: C
authors.lastname: Goonaratna
authors.forename: Padmal
authors.initials: P
authors.lastname: de Silva
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy; D019546:Couples Therapy; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D012731:Sex Counseling; D020018:Sexual Dysfunctions, Psychological / Q000523:psychology / Q000628:therapy*; D012747:Sexual Partners / Q000523:psychology; D013188:Sri Lanka