5 vaginismus treatment options :

Vaginismus is a condition in which the vagina tightens or spasms in response to penetration, causing discomfort, pain and often prevents sexual activity, with it effecting between 0.5-1% of women (Simons, & Carey’s 2001) 10’s of thousands of women in the UK are prevented from enjoying a full sex life by something which for most can be cured.

1)    Couples therapy – One study of 56 couples achieved an 80.3% success rate as defined by achieving penetration (Munasinghe, et al 2004), with another similar study achieving a remarkably similar outcome, which was sustained at a three month follow up (Hawton & Catalan 1990). However, couple’s therapy requires both partners to cooperate and coordinate their time table, which can be a significant limiter.

2)    Pelvic floor exercises – Widely used in sex therapy, research into pelvic floor exercises for Vaginismus is in its early days (Reissing et al 2013) but has demonstrated additive benefits to dilator therapy (see in systematic desensitisation).

3)    Systematic Desensitisation – This is the graded exposure to vaginal penetration, often by the use of a series of different sized dilators (essentially dildos) or the insertion of fingers (1finger, then 2 fingers etc). This is accompanied by relaxation exercises to counter the tensing which accompanies vaginismus and often new thought patterns. Most commonly the relaxation and new thoughts are taught in a session with a hypnotherapist of Cognitive behavioural therapist and then put into practice in private at home. Success rates are extremely high, with one study (Jeng et al 2006) finding that 83.3% of the women in study having regular intercourse with orgasm at one year review, and and many studies achieving 100% intercourse at or before the completion of the study (Biswas & Ratnam 1995, ter Kuile et al 2007, Reamy 1982).

4)    Surgery – Hymenectomy is the most common approach which has been employed, evidence suggests that for Vaginismus it simply does not work (Katz & Tabisel 2001).

5)    Botox – Although a variety of techniques have been used, most botox approaches use injection into the pelvic floor muscles (Pacik 2011). Success rates vary from 75% (Ghazizadeh &, Nikzad  2004) up to 100% (El-Sibai 2000), at completion of therapy, with many studies showing a good retention of benefits at 1 to 2 year follow up (Pacik 2011, Bertolasi et al 2008).

 

portraitThe Author

Matt Krouwel is a hypnotherapist in Birmingham who works with a variety of issues including specialisms in Psychosexual disorders, including vaginismus and  Erectile dysfunction. 0121 476 6751

 

References

Bertolasi, L., Frasson, E., & Graziottin, A. (2008). Botulinum toxin treatment of pelvic floor disorders and genital pain in women. Current Women’s Health Reviews, 4(3), 180-187

Biswas, A., & Ratnam, S. S. (1995). Vaginismus and outcome of treatment. Annals of the Academy of Medicine, Singapore, 24(5), 755.

El-Sibai, A. S. O. (2000). Vaginismus: results of treatment with botulin toxin. Journal of Obstetrics & Gynecology, 20(3), 300-302.

Hawton, K., & Catalan, J. (1990). Sex therapy for vaginismus: characteristics of couples and treatment outcome. Sexual and marital therapy, 5(1), 39-48.

Ghazizadeh S, Nikzad M (2004) Botulinum toxin in the treatment of refractory vaginismus. Obstet Gynecol. 2004 Nov;104(5 Pt 1):922-5.

Jeng, C. J., Wang, L. R., Chou, C. S., Shen, J., & Tzeng, C. R. (2006). Management and outcome of primary vaginismus. Journal of sex & marital therapy, 32(5), 379-387.

Katz, D., & Tabisel, R. L. (2001). Is surgery the answer to vaginismus?. Obstetrics & Gynecology, 97(4), S27

Munasinghe, T., Goonaratna, C., & de Silva, P. (2004). Couple characteristics and outcome of therapy in vaginismus. Ceylon Medical Journal, 49(2), 54-57.

Pacik, P. T. (2011). Vaginismus: review of current concepts and treatment using botox injections, bupivacaine injections, and progressive dilation with the patient under anesthesia. Aesthetic plastic surgery, 35(6), 1160-1164.

Read, S., King, M., & Watson, J. (1997). Sexual dysfunction in primary medical care: prevalence, characteristics and detection by the general practitioner. Journal of Public Health, 19(4), 387-391.

REAMY, K. (1982). The treatment of vaginismus by the gynecologist: An eclectic approach. Obstetrics & Gynecology, 59(1), 58-62

Reissing, E. D., Armstrong, H. L., & Allen, C. (2013). Pelvic Floor Physical Therapy for Lifelong Vaginismus: A Retrospective Chart Review and Interview Study. Journal of sex & marital therapy, 39(4), 306-320.

Simons, J. S., & Carey, M. P. (2001). Prevalence of sexual dysfunctions: results from a decade of research. Archives of Sexual Behavior, 30(2), 177-219.

ter Kuile, M. M., van Lankveld, J. J., Groot, E. D., Melles, R., Neffs, J., & Zandbergen, M. (2007). Cognitive-behavioral therapy for women with lifelong vaginismus: Process and prognostic factors. Behaviour research and therapy, 45(2), 359-373.