title: Therapist-aided exposure for women with lifelong vaginismus: a replicated single-case design.
abstract: Vaginismus is commonly described as a persistent difficulty in allowing vaginal entry of a penis or other object. Lifelong vaginismus occurs when a woman has never been able to have intercourse. A replicated single-case A-B-phase design was used to investigate the effectiveness of therapist-aided exposure for lifelong vaginismus. A baseline period (Phase A) was contrasted with exposure + follow-up (Phase B), using random switching between phases. The main outcome measure (intercourse ability) was assessed daily for 24 weeks. Ten women participated. The exposure consisted of a maximum of three 2-hr sessions during 1 week at a university hospital. The participant performed vaginal penetration exercises on herself, in the presence of a female therapist. Two follow-up sessions were scheduled over a 5-week period. Nine of the 10 participants reported having intercourse after treatment, and in 5 of the 9, intercourse was possible within the 1st week of treatment. The results remained at 1-year follow-up. Furthermore, exposure was successful in decreasing fear and negative penetration beliefs posttreatment and at 3-month and 1-year follow-ups. Therapist-aided exposure appears to be an effective treatment for lifelong vaginismus.
authors.affiliation: Outpatient Clinic of Psychosomatic Gynecology and Sexology (VRSP), Leiden University Medical Center.
authors.forename: Moniek M
authors.initials: MM
authors.lastname: Ter Kuile
authors.affiliation: Katholieke Universiteit Leuven.
authors.forename: Isis
authors.initials: I
authors.lastname: Bulté
authors.affiliation: Outpatient Clinic of Psychosomatic Gynecology and Sexology (VRSP), Leiden University Medical Center.
authors.forename: Philomeen T M
authors.initials: PTM
authors.lastname: Weijenborg
authors.affiliation: Outpatient Clinic of Psychosomatic Gynecology and Sexology (VRSP), Leiden University Medical Center.
authors.forename: Aart
authors.initials: A
authors.lastname: Beekman
authors.affiliation: Outpatient Clinic of Sexology, Maastricht University Medical Center.
authors.forename: Reinhilde
authors.initials: R
authors.lastname: Melles
authors.affiliation: Katholieke Universiteit Leuven.
authors.forename: Patrick
authors.identifier: 0000-0002-3986-8312
authors.initials: P
authors.lastname: Onghena
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011369:Professional-Patient Relations; D012720:Severity of Illness Index; D020018:Sexual Dysfunctions, Psychological / Q000523:psychology; D014621:Vagina / Q000503:physiopathology; D052065:Vaginismus / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D055815:Young Adult