Interventions for vaginismus

McGuire H, Hawton KKE

Published Online:

January 21, 2009

Vaginismus is when the muscles in the vagina tighten and prevent a woman from having sex. It can cause distress, relationship problems and also infertility. Many treatments have been tried including sex therapy, education, hypnosis and drug treatments. Therapy may involve relaxation techniques and gradually inserting a dilator or finger into the vagina. (This may be called systematic desensitization or flooding.) This review found only three studies. None of the studies compared treatments with no treatment. On the basis of these studies we cannot draw conclusions about how well treatments for vaginismus work. Uncontrolled reports suggest that sex therapy may be helpful. Further studies are needed to confirm this.

Abstract (click to read)

Background:

Vaginismus is an involuntary contraction of the vaginal muscles which makes sexual intercourse difficult or impossible. It is one of the more common female psychosexual problems. Various therapeutic strategies for vaginismus, such as sex therapy and desensitization, have been proposed, and uncontrolled case series appear promising..

Objectives:

The aim of this review is to determine the clinical effectiveness of treatments for vaginismus and also to examine the role of partner participation in the effectiveness of the treatment.

Search strategy:

The Cochrane Collaboration Depression, Anxiety & Neurosis Controlled Trials Register (carried out on 23/5/2005), the Cochrane Controlled Trials Register (Cochrane Library, Issue 4, 2004), MEDLINE (1966 to Feb 2005), EMBASE (1980 to Feb 2005), PsycINFO (1967 to Feb 2005) and CINAHL (1982 to Feb 2005) were searched. The Journal of Sex Research (1974 to 1999), Sexual & Marital Therapy (1986 to 1999), Sexual Dysfunction (1998 to 1999) and the Journal of Sex and Marital Therapy (1974 to 1999) were handsearched. Reference lists and conference abstracts were searched. Experts in the field were contacted regarding unpublished material.

Selection criteria:

Controlled trials comparing treatments for vaginismus with another treatment, a placebo treatment, treatment as usual or waiting list control.

Data collection and analysis:

The reviewers extracted data which were verified with the trial investigator where possible.

Main results:

Three potential trials were identified, but data were only available from two of these. One trial comparing two forms of systematic desensitization with hypnotherapy was excluded because it was not randomised. The included trial compared two forms of systematic desensitization and reported no discernible differences between them.

Authors' conclusions:

In spite of encouraging results reported from uncontrolled case series there is very limited evidence from controlled trials concerning the effectiveness of treatments for vaginismus. Further trials are needed to compare therapies with waiting list control and with other therapies.

This record should be cited as:

McGuire H, Hawton KKE. Interventions for vaginismus. Cochrane Database of Systematic Reviews 2003, Issue 1. Art. No.: CD001760. DOI: 10.1002/14651858.CD001760

Assessed as up to date:

May 23, 2005

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Primary Review Group:

Depression, Anxiety and Neurosis Group

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