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Interventions for vaginismus.

Tamara Melnik1, Keith Hawton, Hugh McGuire

  • 1Brazilian Cochrane Centre,Universidade Federal de São Paulo, São Paulo, Brazil.

The Cochrane Database of Systematic Reviews
|December 14, 2012
PubMed
Summary
This summary is machine-generated.

Systematic desensitization shows no significant difference compared to control interventions for vaginismus treatment. However, higher dropout rates were observed in waiting list groups, suggesting potential benefits not fully captured by current evidence.

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Area of Science:

  • Psychology
  • Gynecology
  • Sexual Health

Background:

  • Vaginismus involves involuntary vaginal muscle contractions, causing painful intercourse and affecting female sexual health.
  • It is a prevalent psychosexual issue, with various therapies like sex therapy and desensitization proposed.
  • Uncontrolled studies suggest promising outcomes for existing vaginismus treatments.

Purpose of the Study:

  • To systematically evaluate the effectiveness of different interventions for vaginismus.
  • To compare various therapeutic strategies against control groups in randomized controlled trials.

Main Methods:

  • Searched major databases (Cochrane, EMBASE, MEDLINE, PsycINFO) up to August 2012 for relevant randomized controlled trials.
  • Included controlled trials comparing vaginismus treatments against placebo, usual care, or waiting list controls.
  • Extracted data from included studies, verifying with investigators where possible; meta-analysis was precluded by study heterogeneity.

Main Results:

  • Four studies with 282 participants provided data; meta-analysis was not feasible due to heterogeneity and data reporting issues.
  • Systematic desensitization demonstrated no significant clinical or statistical difference compared to waiting list control, group therapy, or in vitro desensitization.
  • Dropout rates were notably higher in waiting list control groups compared to intervention groups.

Conclusions:

  • A clinically relevant effect of systematic desensitization cannot be definitively ruled out despite a lack of statistical difference.
  • The current evidence base is limited, with no trials comparing behavioral therapies to pharmacological interventions for vaginismus.
  • Conclusions regarding the efficacy of vaginismus treatments must be drawn cautiously due to the available evidence limitations.