Cognitive-behavioral therapy for women with lifelong vaginismus: A randomized waiting-list controlled trial of efficacy.

Abstract

Women with lifelong vaginismus (N=117) were randomly assigned to cognitive-behavioral group therapy, cognitive-behavioral bibliotherapy, or a waiting list. Manualized treatment comprised sexual education, relaxation exercises, gradual exposure, cognitive therapy, and sensate focus therapy. Group therapy consisted of ten 2-hr sessions with 6 to 9 participants per group. Assistance with minimal-contact bibliotherapy consisted of 6 biweekly, 15-min telephone contacts. Twenty-one percent of the participants left the study before posttreatment assessment. Intent-to-treat analysis revealed that successful intercourse at posttreatment was reported by 14% of the treated participants compared with none of the participants in the control condition. At the 12-month follow-up 21% of the group therapy participants and 15% of the bibliotherapy participants, respectively, reported successful intercourse. Cognitive-behavioral treatment of lifelong vaginismus was thus found to be efficacious, but the small effect size of the treatment warrants future efforts to improve the treatment.

The assessment of penetration cognitions and sexual functionality of women with sexual pain disorder in a Turkish sample: a comparative study

“…Many recent studies represent that women with vaginismus have wide range of sexual problems, [15][16][17][18][19][20][21][22][23][24][25][26][27] and at least one study disclose that these sexual problems bear a resemblance to women with dyspareunia. 41 Our findings support the results of these recent studies.…”

“…5,15-20-24 Besides, in case-control studies it was found that women with vaginismus specifically have lower level of sexual drive, arousal, lubrication, orgasm and satisfaction than those healthy controls. 22,[25][26][27] Recently, studies regarding women with lifelong vaginismus in Western countries have started focusing on cognitive and emotional factors concerning sexual penetration behavior. In a study carried out with Vaginal Penetration Cognition Questionnaire 28 (VPCQ), women with vaginismus were reported to have more level of loss of control related to penetration, negative self-cognitions, catastrophe/pain and genital incompatibility cognitions than women with dyspareunia and women with no sexual complaints.…”

Disgust and Contamination Sensitivity in Vaginismus and Dyspareunia

“…These complaints often have a chronic course and may result in considerable emotional distress (e.g., ter Kuile et al, 2007). Unfortunately, the etiology of this ''perplexing condition'' is largely unknown (Leiblum, 2000) and currently available treatment strategies are not very effective in reducing these complaints (e.g., van Lankveld et al, 2006).…”

A Prospective 2-Year Examination of Cognitive and Behavioral Correlates of Provoked Vestibulodynia Outcomes

“…It also provides a temporal framework to work within, as the therapist must initially focus on challenging negative cognitions before explicitly addressing avoidance behaviors. A similar model has been used in the cognitive-behavioral treatment of vaginismus, with improvements using both group therapy and bibliotherapy 16 . In particular, the actual behavioral engagement in the fear provoking stimuli (vaginal penetration) was shown to predict less fear of pain at later time points, and both fear of pain and penetration behaviors mediated outcomes 17 .…”