Use by gynecologists of a modified sensate focus technique to treat vaginismus causing infertility

Jindal, Umesh; Jindal, Sheetal

doi:10.1016/j.fertnstert.2010.03.071

Cited by 26 publications

(15 citation statements)

References 20 publications

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“…A behavioural approach involving education, counselling and sensate focus techniques for affected couples as well as desensitisation of the vulva and vagina have been shown to be a successful in resolving vaginismus and achieving pregnancy. Emphasis was put on the importance of including the partner in treatment because male partners can develop secondary erectile dysfunction . Surgical interventions as well as multidisciplinary methods using desensitisation, counselling and education have been shown to be successful treatments for LPV …”

Section: Discussionmentioning

confidence: 99%

“…Little is known about the afflicted women's reproduction, pregnancy and delivery outcome. Because of severe pain and/or vaginal spasm, these women might be unable to engage in vaginal intercourse and so suffer from infertility . A register‐based study in an Israeli hospital during the years 1988–2007 found an increased risk for delivery by caesarean section, vacuum extraction and the need to induce labour in women with vaginismus .…”

Section: Introductionmentioning

confidence: 99%

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Reproduction and mode of delivery in women with vaginismus or localised provoked vestibulodynia: a Swedish register‐based study

Möller

Josefsson

Bladh

et al. 2014

BJOG

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Objective To compare sociodemographics, parity and mode of delivery between women diagnosed with vaginismus or localised provoked vestibulodynia (LPV) to women without a diagnosis before first pregnancy.Design Retrospective, population-based register study.Setting Sweden.Sample All women born in Sweden 1973-83 who gave birth for the first time or remained nulliparous during the years 2001-09.Methods Nationally linked registries were used to identify the study population. Women diagnosed with vaginismus or LPV were compared to all other women. Odds ratios for parity and mode of delivery were calculated using multinominal regression analysis and logistic regression.Main outcome measures Parity and mode of delivery.Results Women with vaginismus/LPV were more likely to be unmarried (P = 0.001), unemployed (P = 0.012), have a higher educational level (P < 0.001), a lower body mass index (P < 0.001) and use nicotine during pregnancy (P = 0.008). They were less likely to give birth (adjusted odds ratio [OR] 0.61, 95% confidence interval [95% CI] 0.56-0.67). Women with vaginismus/LPV more often delivered by caesarean section (P < 0.001) especially for maternal request (adjusted OR 3.48, 95% CI 2.45-4.39). In women having vaginal delivery, those with vaginismus/LPV were more likely to suffer a perineal laceration (adjusted OR 1.87, 95% CI 1.56-2.25).Conclusions Women with vaginismus/LPV are less likely to give birth and those that do are more likely to deliver by caesarean section and have a caesarean section based upon maternal request. Those women delivering vaginally are more likely to suffer perineal laceration. These findings point to the importance of not only addressing sexual function in women with vaginismus/LPV but reproductive function as well.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reproduction and mode of delivery in women with vaginismus or localised provoked vestibulodynia: a Swedish register‐based study

Möller

Josefsson

Bladh

et al. 2014

BJOG

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“…There was complete symptomatic resolution of vaginismus in 60 women, and 52% conceived spontaneously. Although the authors do not specify how long it took to achieve those pregnancies, the treatment protocol was completed in 6 weeks [10].…”

Section: Spds and Conceptionmentioning

confidence: 99%

Managing Pregnancy and Delivery in Women with Sexual Pain Disorders (CME)

Rosenbaum¹,

Padoa²

2012

The Journal of Sexual Medicine

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“…For example, some existing research suggests that infertility may be associated with an increase in pain related to the stress of infertility and its treatment. 12 Pain may be a factor in infertility when superficial dyspareunia makes intercourse difficult to achieve 13 or deep dyspareunia makes intercourse difficult to sustain, 14 sometimes causing affected individuals to avoid sexual stimuli. 15 In the latter cases, it may be the interruption or avoidance of intercourse, rather than infertility related to abnormalities in ovulation, fertilization, or implantation, that reduces the likelihood of pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Deep Dyspareunia, Superficial Dyspareunia, and Infertility Concerns Among Women With Endometriosis: A Cross-Sectional Study

Wahl

Orr

Lisonek³

et al. 2020

Sexual Medicine

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Introduction: Deep dyspareunia is a cardinal symptom of endometriosis, and as many as 40% of people with this condition experience comorbid superficial dyspareunia. Aim: To evaluate the relationship between sexual pain and infertility concerns among women with endometriosis. Methods: This is a cross-sectional study conducted at a university-based tertiary center for endometriosis. 300 reproductive-aged participants in the prospective Endometriosis Pelvic Pain Interdisciplinary Cohort (ClinicalTrials.gov Identifier: NCT02911090) with histologically confirmed endometriosis were included (2013e2017). Main Outcome Measure: The total score on the infertility concerns module of the Endometriosis Health Profile-30 categorized into 5 groups (0, 1e4, 5e8, 9e12, 13e16). Results: The odds of infertility concerns did not increase with severity of deep dyspareunia (odds ratio ¼ 1.02, 95% CI: 0.95e1.09, P ¼ .58). However, the odds of infertility concerns increased with severity of superficial dyspareunia (odds ratio ¼ 1.09, 95% CI: 1.02e1.16, P ¼ .011); this relationship persisted after adjusting for endometriosis-specific factors, infertility risk factors, reproductive history, and demographic characteristics (adjusted odds ratio [AOR] ¼ 1.14, 95% CI: 1.06e1.24, P < .001). Other factors in the model independently associated with increased infertility concerns were previous difficulty conceiving (AOR ¼ 2.09, 95% CI 1.04e4.19, P ¼ .038), currently trying to conceive (AOR ¼ 5.23, 95% CI 2.77e9.98, P < .001), nulliparity (AOR ¼ 3.21, 95% CI 1.63e6.41, P < .001), and younger age (AOR ¼ 0.94, 95% CI: 0.89e0.98, P ¼ .005). Conclusion: Severity of superficial dyspareunia, but not deep dyspareunia, was associated with increased odds of infertility concerns among women with endometriosis. Strengths of the study included the use of a validated measure of infertility concerns and disaggregation of sexual pain into deep and superficial dyspareunia. Limitations included the setting of a tertiary center for pelvic pain, which affects generalizability to fertility clinic and primary care settings. Women experiencing introital dyspareunia, who can have difficulties with achieving penetrative intercourse, may be concerned about their future fertility and should be counselled appropriately.

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Use by gynecologists of a modified sensate focus technique to treat vaginismus causing infertility

Cited by 26 publications

References 20 publications

Reproduction and mode of delivery in women with vaginismus or localised provoked vestibulodynia: a Swedish register‐based study

Reproduction and mode of delivery in women with vaginismus or localised provoked vestibulodynia: a Swedish register‐based study

Managing Pregnancy and Delivery in Women with Sexual Pain Disorders (CME)

Deep Dyspareunia, Superficial Dyspareunia, and Infertility Concerns Among Women With Endometriosis: A Cross-Sectional Study

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