Although vaginismus is a relatively common female sexual dysfunction in Iran, there are scant studies reporting on its clinical and social features. The aim of the present study was to compare the social and clinical characteristics of women with vaginismus with those of healthy women. The study comprises 22 patients with vaginismus and 22 healthy controls who presented to the health clinics of Tehran University of Medical Sciences, Iran. We used three assessment tools: interview, a (34-item) questionnaire for demographic and clinical characteristics of vaginismus and a 13-item questionnaire of Female Sexual Distress Scale-Revised (FSDS-R) for sexual distress. The majority (73%) of women with vaginismus had primary vaginismus (unconsummated marriage). These women demonstrated significant higher phobia than healthy women, including fear of genital pain and penetration, fear of bleeding during intercourse, height phobia, aversion to looking or touching the genitalia, fear of vaginal disproportion and also disgust of semen. Compared with the healthy women, these women displayed a significantly higher sexual distress score, defecation or urination problems, general anxiety, higher education levels and lower self-esteem. Our findings suggest that there is a strong correlation between vaginismus, phobia and anxiety.
Introduction Sexuality is an important aspect of human life and sexual problems are common, but there is limited evidence for cost-effective treatments of women's sexual dysfunctions. Aims The aim of this study was to assess whether group therapy such as Sexual Health Model (SHM) can be as effective as individual therapy like Permission, Limited Information, Specific Suggestions, and Intensive Therapy (PLISSIT) model in women with sexual problems. Methods A randomized controlled trial was conducted between May 2012 and September 2013 in five Tehran, Iran health clinics. Eighty-four consecutive married women aged 20–52 years, with sexual problems who were admitted for the first time, were recruited and randomized into two groups. The intervention included two therapeutic models: the SHM, which consisted of two sessions of 3 hours of group education, and the PLISSIT model, which required a total of 6 hours of one-on-one consultation at an interval of 1–2 weeks. Main Outcome Measures Sexual function and sexual distress were assessed, respectively, with the Brief Index of Sexual Function for Women and Female Sexual Distress Scale Revised questionnaires. Results Seven months after intervention, the mean (SD) of the sexual distress score decreased and sexual composite score increased significantly in both groups (P < 0.001). The overall analysis of repeated measure manova revealed borderline significance differences for combined outcomes between two groups (P = 0.051). Conclusions Due to the considerable human resource, time, and cost spent conducting the PLISSIT, it seems that group education based on SHM could be more cost-efficient and nearly as effective. This conclusion may be more applicable in communities where the treatment of sexual problems is in the beginning stages and where people have not received any sexual education or knowledge during their lifetime.
This study examined the effect of selected sexual and nonsexual aspects of pre-marriage counseling on the marital satisfaction of Iranian newlywed couples. A sample of 200 couples was divided randomly into two groups, one group receiving ordinary education (the no intervention group, NIG), the other group receiving special education (the intervention group, IG). IG couples attended four lecture sessions given by the researchers consisting of family planning, personal health, different aspects of sexuality, communication and conflict resolution skills. NIG couples attended lectures presented in the normal preparation program, based on just family planning and personal health. All lectures were given a few months prior to marriage, and then marital satisfaction was assessed 4 months after marriage with 40 questions of the ENRICH questionnaire. Final analysis was based on 64 completed questionnaires. The results indicated that, 4 months after marriage, sexual, nonsexual and marital satisfaction in IG was significantly higher than in the control group.
Introduction To date, few studies have investigated the prevalence of sexual pain in the context of the new diagnostic concept of genito-pelvic pain/penetration disorder (GPPPD). Aim To evaluate the prevalence of GPPPD and its associated factors. Methods This was a population-based, cross-sectional study of 590 healthy married women age 18–70 years conducted between May and October 2017 in Tehran, Iran. Main Outcome Measures Research tools included demographic characteristics checklist, factors affecting GPPPD, sexual distress and self-reporting of pain during intercourse, 2 standard questionnaires on depression (Patient Health Questionnaire 9) and Binik’s guideline for the diagnosis of GPPPD. Results 196 women (33%) reported pain or fear in answer to self-report questions. Administration of Binik’s guideline yielded a GPPPD prevalence of 16% (n = 94 women); however, this number decreased to 62 women (10.5%) when sexual distress was taken into account; thus, the final prevalence of GPPPD was considered to be 10.5%. However, if the threshold in Binik’s guideline was lowered to also include those reporting “somewhat” pain in addition to the group reporting “moderate” and “quite a bit or always,” then the prevalence of GPPPD increased to 25.8%. The results of backward logistic regression identified a strong aversion to looking at or touching the genitalia (odd ratio [OR] = 4.3), low sexual satisfaction (OR = 3.1), and severe depression (OR = 6.6) as independent risk factors for a diagnosis of GPPPD and secure financial status (OR = 0.3) and a high level of marital satisfaction (OR = 0.2) as protective factors against a diagnosis of GPPPD. Clinical Implications Reliable diagnosis of GPPPD is crucial. Application of validated tools may mitigate the overestimation of GPPPD prevalence. Simultaneously, clinicians’ judgment is essential in assessing a reasonable threshold and preventing underestimation that leads to the exclusion of women suffering from pain. Strengths & Limitations The present study is one of the few evaluating the prevalence of GPPPD according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) definition and Binik’s guideline. The study also aims to point out some new perspectives on merging the 2 concepts of vaginismus and dyspareunia. Study limitations include the evaluation of factors affecting GPPPD based on self-reporting and possible recall bias. Conclusion Further research is needed to determine the appropriate threshold for a diagnosis of GPPPD. We suggest that a woman with mild to moderate pain or fear of vaginal penetration is under sexual distress and cannot be neglected. In addition, problems may arise following the DSM-5 merging of the 2 disorders of vaginismus and dyspareunia, owing to the significant prevalence and distress of lifelong vaginismus in some cultures.
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