Factors affecting the recovery time in vaginismus

Year 2021, , 52 - 63, 01.04.2021

Elif Aktan Mutlu , Rıfat Karlıdağ

https://doi.org/10.25279/sak.552121

Abstract

Aim:
To examine the factors that had an impact on the treatment duration in patients
presenting with a diagnosis of vaginismus. 

Method:
This retrospective study included 62 patients who received cognitive behavioral
therapy for vaginismus. Golombok Rusk Inventory of Sexual Satisfaction (GRISS),
Sexual Myths Scale tests and a socio-demographic questionnaire were applied to
all patients. Those who responded to the treatment in the first 7 weeks were
classified as 'early responders' and others as 'non-early responders’ and
factors that may affect the responses were investigated.

Results:
Thirty-two patients were early responders (52%) and 30 patients were late/no
responders (48%). Concerns regarding the pain experienced by the spouse
(OR:7.4, 95% CI: 1.02-54.2, p=0.048) and the idea that sexual intercourse
should always be initiated by the male partner (OR:8.98, 05% CI:1.07-75.38,
p=0.043) emerged as predictors of late/no response in multivariate analysis.

Conclusion:
Concern for female partners’ pain during sexual intercourse among male
partners, and the sexual myth of “sexual intercourse should always be initiated
by the male partner” among female partners seems to effect treatment response. Prospective
studies in different populations are needed in the future. Prospective studies
in different populations are needed in the future. 

Keywords

Vaginismus, Treatment response, Cognitive behavioral therapy

Vajinismusda iyileşme süresine etki eden faktörler

Abstract

Giriş: Vajinismus tanısı almış
hastaların tedavi süresine etki eden faktörleri belirlemektir.

Gereç ve Yöntem: Bu çalışmaya
vajinismus için bilişsel davranışçı tedavi almış 62 hasta dahil edilmiştir. Tüm
hastalara Golombok Rusk Inventory of Sexual Satisfaction (GRISS), Sexual Myths
Scale testleri uygulanmış ve bir sosyo-demografik soru formu verilmiştir.
Tedaviye ilk 7 haftada yanıt verenler ‘erken yanıt verenler’, diğerleri ise
‘geç yanıt veren ya da yanıt vermeyenler’ olarak sınıflandırılmış, yanıt durumu
üzerine etki edebilecek faktörler araştırılmıştır.

Bulgular: Otuz iki hasta erken
yanıt vermiş (52%), 30 hasta ise geç yanıt vermiş ya da yanıt vermemiştir
(48%). Çok değişkenli analizde, eşin acı çekeceği endişesi (OR:7.4, 95% CI:
1.02-54.2, p=0.048) ve cinsel ilişkiyi her zaman erkek başlatmalıdır düşüncesi (OR:8.98,
05% CI:1.07-75.38, p=0.043) geç yanıt/yanıtsızlık için belirleyici olarak
bulunmuştur.  Sonuç: Erkek partnerin
eşinin cinsel ilişki sırasında acı çekeceği endişesi ve kadın partnerin cinsel
ilişkiyi her zaman erkek başlatmalıdır şeklindeki düşüncesi tedavi yanıtını
etkiliyor görünmektedir. Gelecekte değişik popülasyonlarda yapılacak prospektif
çalışmalara ihtiyaç vardır.

Keywords

vaginismus, tedavi yanıtı, bilişsel davranışçı terapi

References

• American Psychiatric Association DSM-5 Diagnostic and statistical manual for mental disorders. (2013). (Fifth ed.). USA: American Psychiatric Press.
• Amick, H. R., Gartlehner, G., Gaynes, B. N., Forneris, C., Asher, G. N., Morgan, L. C., . . . Gaylord, S. (2015). Comparative benefits and harms of second generation antidepressants and cognitive behavioral therapies in initial treatment of major depressive disorder: systematic review and meta-analysis. Bmj, 351, h6019.
• Atmaca, M., Baykara, S., Ozer, O., Korkmaz, S., Akaslan, U., & Yildirim, H. (2016). Hippocampus and amygdala volumes in patients with vaginismus. World J Psychiatry, 6(2), 221-225. doi:10.5498/wjp.v6.i2.221
• Dağ, H., Dönmez, S., & Kavlak, O. (2012). Kadın cinselliğinin gizlenen yönü: Vajinismus ve hemşirenin rolü. Sürekli Tıp Eğitimi Dergisi, 21(5), 43-47.
• Dogan, S. (2006). [Sexual aversion disorder: a case of favourable outcome and rapid response to behavioral therapy]. J Clin Psy, 9(4), 191-197.
• Dogan, S., & Ozkorumak, E. (2008). [Painful sexual genital activity and difficulties in diagnosis of vaginismus]. Klinik Psikiyatri, 11(3), 135-142.
• Dogan, S., & Saracoglu, G. (2009). [The assessment of sexual knowledge, marital characteristics, sexual function and satisfaction in women with lifelong vaginismus]. Trakya Univ Tip Fak Derg, 26(2), 151-158.
• Evcili, F., & Golbasi, Z. (2017). Sexual myths and sexual health knowledge levels of Turkish university students Sexuality & Culture, 21 (4), 976-990.
• Fadul, R., Garcia, R., Zapata-Boluda, R., Aranda-Pastor, C., Brotto, L., Parron-Carreno, T., & Alarcon-Rodriguez, R. (2018). Psychosocial correlates of vaginismus diagnosis: A case-control study. J Sex Marital Ther, 1-23. doi:10.1080/0092623X.2018.1484401
• Fadul, R., Garcia, R., Zapata-Boluda, R., Aranda-Pastor, C., Brotto, L., Parron-Carreño, T., & Alarcon-Rodriguez, R. (2019). Psychosocial Correlates of Vaginismus Diagnosis: A Case-Control Study. Journal of sex & marital therapy, 1-11.
• Farnam, F., Janghorbani, M., Merghati-Khoei, E., & Raisi, F. (2014). Vaginismus and its correlates in an Iranian clinical sample. Int J Impot Res, 26(6), 230-234. doi:10.1038/ijir.2014.16
• Hawton, K., & Catalan, J. (1990). Sex therapy for vaginismus: Characteristics of couples and treatment outcome. Sexual and Marital Therapy, 5(1), 39-48. doi:10.1080/02674659008407995
• Incesu, S. (2006). [Sexual life and problems]. Istanbul: Cinsel Egitim Tedavi ve Arastirma Dernegi.
• Kayır, A. (1998). Cinsellik kavramı ve cinsel mitler. Cinsel işlev bozuklukları monograf serisi, 1, 30-35. Korkmaz, C. S., Bildik, T., Erermis, S., Demiral, N., Ozbaran, B., Tamar, M., & Aydin, C. (2008). [Sexual behavior and sources of information about sex among male adolescents: an 8-year follow-up]. Turk Psikiyatri Derg, 19(4), 390-397.
• Lamont, J. A. (1978). Vaginismus. Am J Obstet Gynecol, 131(6), 633-636.
• Laumann, E. O., Gagnon, J. H., Michael, R. T., & Michael, S. (1994). The social organization of sexuality: sexual practices in the United States. Chicago: The University of Chicago.
• Leiblum, S. R., & Goldmeier, D. (2008). Persistent genital arousal disorder in women: case reports of association with anti-depressant usage and withdrawal. J Sex Marital Ther, 34(2), 150-159. doi:10.1080/00926230701636205
• Masters, W. H., & Johnson, V. E. (1970). Human sexual inadequacy (First ed.). Boston: Little Brown & Company.
• Oksuz, E., & Malhan, S. (2006). Prevalence and risk factors for female sexual dysfunction in Turkish women. J Urol, 175(2), 654-658. doi:10.1016/S0022-5347(05)00149-7
• Ozdel, O., Tumkaya, S., Levent, N., Atesci, F. C., & Oguzhanoglu, N. K. (2013). [Effects of sex therapy based on cognitive behavioral methods on sexual problems of women with vaginismus and their spouses]. Anadolu Psikiyatri Derg, 14(2), 129-153.
• Reissing, E. D., Binik, Y. M., & Khalife, S. (1999). Does vaginismus exist? A critical review of the literature. J Nerv Ment Dis, 187(5), 261-274.
• Rust, J., & Golombok, S. (1985). The Golombok-Rust Inventory of Sexual Satisfaction (GRISS). Br J Clin Psychol, 24 ( Pt 1), 63-64. Tastan, K., & Isik, M. (2015). [Hypnotherapy in the treatment of vaginismus: a case report]. Ankara Med J, 15(1), 35-37. doi:10.17098/amj.44314
• Ter Kuile, M. M., Melles, R. J., Tuijnman-Raasveld, C. C., de Groot, H. E., & van Lankveld, J. J. (2015). Therapist-Aided Exposure for Women with Lifelong Vaginismus: Mediators of Treatment Outcome: A Randomized Waiting List Control Trial. J Sex Med, 12(8), 1807-1819. doi:10.1111/jsm.12935
• Ter Kuile, M. M., Melles, R. J., Tuijnman‐Raasveld, C. C., de Groot, H. E., & van Lankveld, J. J. (2015). Therapist‐aided exposure for women with lifelong vaginismus: mediators of treatment outcome: a randomized waiting list control trial. The journal of sexual medicine, 12(8), 1807-1819. Ter Kuile, M. M., & Reissing, E. D. (2014). Lifelong vaginismus. In Y. M. Binik & K. S. K. Hall (Eds.), Principles and Practice of Sex Therapy (Fifth ed.): Guilford Publications.
• Torun, F. (2010). [Treatment of vaginismus with EMDR: a report of two cases]. Turk Psikiyatri Derg, 21(3), 243-248.
• Torun, F., Torun, S. D., & Özaydın, A. N. (2011). Erkeklerde Cinsel Mitlere İnanma Oranları ve Mitlere İnanmayı Etkileyen Faktôrler. Dusunen Adam: Journal of Psychiatry & Neurological Sciences, 24(1).
• Yasan, A., & Gurgen, F. (2004). [The ways to get sexual knowledge and the comparison of the rate of sexual myths in nurses who have sexual partners and who do not have]. Yeni Symposium, 42(2), 72-76.
• Yetkin, N. (1999). Vaginismus. Sexual function disorders monograph series. Türk Psikiyatri Dizini(3), 26-29.
• Yıldırım, M. H. (2017). Vajinismusun Sosyodemografik ve Klinik Özellikleri Açısından Diğer Cinsel İşlev Bozuklukları ile Karşılaştırılması. Klinik Psikiyatri Dergisi, 20(1).
• Zilbergeld, B. (1999). The new male sexuality: Bantam.