Therapist-aided exposure for women with lifelong vaginismus: a randomized waiting-list control trial of efficacy.
OBJECTIVE
Vaginismus is commonly described as a persistent difficulty in allowing vaginal entry of a penis or other "objects" (e.g., tampons, fingers, speculum). Lifelong vaginismus is diagnosed when a woman has never been able to have intercourse. The aim of this study was to investigate the efficacy of therapist-aided exposure for lifelong vaginismus.


METHODS
Seventy women and their partners were randomly allocated to exposure or a waiting-list control period of 3 months. The main outcome measure (intercourse ability) was assessed daily during 12 weeks. Secondary outcome measures were complaints about vaginismus, coital pain, coital fear, sexual distress, and sexual functioning. The exposure treatment consisted of a maximum of three 2-hr sessions during 1 week at a university hospital. Each participant performed vaginal penetration exercises herself, in the presence of her partner and a female therapist. Two follow-up sessions were scheduled over a 5-week period.


RESULTS
Thirty-one out of 35 (89%; 95% CI [72%, 96%]) participants reported having had sexual intercourse at posttreatment compared with 4 out of 35 (11%; 95% CI [4%, 28%]) participants in the control condition. In most of the successfully treated women (90%), intercourse was possible within the first 2 weeks of treatment. Moreover, treatment resulted in clinical improvement regarding other symptoms related to vaginismus, coital fear, coital pain, and sexual distress. No treatment effects were found regarding other aspects of sexual functioning in women or their partners.


CONCLUSIONS
This study provides evidence of the efficacy of therapist-aided exposure therapy for women with lifelong vaginismus.
Outpatient Clinic of Psychosomatic Gynecology and Sexology, Gynecology Department, Leiden University Medical Center.
Moniek M
MM
Ter Kuile
Outpatient Clinic of Sexology, Maastricht University Medical Center.
Reinhilde
R
Melles
Outpatient Clinic of Psychosomatic Gynecology and Sexology, Gynecology Department, Leiden University Medical Center.
H Ellen
HE
de Groot
Outpatient Clinic of Psychosomatic Gynecology and Sexology, Gynecology Department, Leiden University Medical Center.
Charlotte C
CC
Tuijnman-Raasveld
Department of Psychology, Open Universiteit.
Jacques J D M
0000-0003-0956-4067
JJDM
van Lankveld
D000328:Adult; D003075:Coitus / Q000523:psychology; D003469:Culture; D005239:Fear; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007171:Implosive Therapy / Q000379:methods*; D011369:Professional-Patient Relations; D012944:Social Support; D052065:Vaginismus / Q000523:psychology* / Q000628:therapy*; D055815:Young Adult