Marriage consummated for 32 Iranian women using therapist-aided exposure therapy: a brief report

Abstract

This brief report discusses the effectiveness of therapist-aided gradual exposure therapy for a sample of women suffering from lifelong vaginismus (LLV). Thirty two women who have never been able to have sexual intercourse, performed weekly exposure sessions of vaginal penetration exercises assisted by a female therapist/sexologist, at the (Isfahan) psychosexual clinic. The main outcome measures were the diary kept by the female participants and their partners achieving successful intercourse. After the treatment, all women reported having successful intercourse. This result was maintained during two follow-up sessions over a six-month period. At the second follow-up session, all participants and their spouses revealed a significant decrease in fear scores compared with the pre-treatment (for women and their spouses, t (31) = 15.43, p < 0.00 and t (31) = 13.41, p < 0.00, respectively). Although we had no experimental control group, this therapeutic method demonstrated an effective approach in reducing coital fear and negative beliefs commonly associated with vaginal penetration in women with vaginismus. Further studies that include a control group and greater sample size are warranted to evaluate the efficacy of therapist-aided exposure therapy for treatment of women with LLV.

Keywords:

• vaginismus
• gradual exposure
• women's sexuality
• clinical psychology
• treatment interventions
• psychosomatic gynecology
• pain

Acknowledgments

This article is part of a PhD thesis in Reproductive Health focused on the sexual behavior patterns of the couples with “unconsummated marriage”, which has been approved by Mashhad University of Medical Sciences, Mashhad, Iran (Code: 900983). The financial support provided by the university is highly appreciated. We gratefully acknowledge Isfahan Psychosexual Clinic staff and our participants. We also appreciate Dr Moniek ter Kuile and her team for their support in providing and assisting us with the treatment protocol. The authors wish to thank Dr Walter Pierre Bouman for his helpful reading of the final draft.

Additional information

Notes on contributors

M. Molaeinezhad

Mitra Molaeinezhad, BSc, MSc, PhD, sexual and reproductive health specialist-clinical sexologist, she is a lecturer/faculty member in Midwifery group, Islamic Azad University, Isfahan (Khorasgan branch). She is also a master's student in clinical psychology. She provides psychosexual therapy in private practice and in Isfahan psychosexual clinic, Isfahan University of Medical Sciences, Isfahan, Iran.

M. Salehi

Mehrdad Salehi, MD, psychiatrist is an associate professor at the Department of Psychiatry, School of Medicine at the Isfahan University of Medical Sciences, Isfahan, Iran. He serves as a lead clinician in Isfahan psychosexual clinic, Isfahan University of Medical Sciences, Isfahan, Iran.

C. Borg

Charmaine Borg, PhD, is a post-doc researcher and lecturer at the Department of Clinical and Experimental Psychopathology at the University of Groningen, Groningen, Netherlands. Her core areas of interest include sexual dysfunctions, sexual arousal, and negative emotions (particularly disgust). She publicly defended her PhD thesis entitled “Sex, disgust, and penetration disorders” in December 2013.

A. Yousefy

Alireza Yousefy, PhD, medical education specialist, is an associate professor at the Medical Education Research Centre at the Isfahan University of Medical Sciences, Isfahan, Iran. His research focuses primarily on the development and psychometric assessment of the psychological inventories and scales. He serves as the editor-in-chief of the Journal of Education and Health Promotion (JEHP).

R. Latifnejad Roudsari

Robab Latifnejad Rudsari, PhD, reproductive health specialist, is an associate professor at the Department of Midwifery, School of Nursing and Midwifery and Research Centre for Patient Safety at the Mashhad University of Medical Sciences, Mashhad, Iran.

P. Salehi

Peyman Salehi, MD, is a urologist and male infertility specialist at the Department of Urology, Infertility clinic, Shahid Beheshti Hospital, at the Isfahan University of Medical Sciences, Isfahan, Iran.

K. Shafiei

Katayun Shafiei, MD, psychiatrist, is an associate professor at the Department of Psychiatry, School of Medicine at the Isfahan University of Medical Sciences, Isfahan, Iran. She serves as a lead clinical psychiatrist in Isfahan psychosexual clinic, Isfahan University of Medical Sciences, Isfahan, Iran.

E. Merghati Khoei

Effat Merghati Khoei, PhD, health promotion-sexologist, drug and sexual risk behavior prevention fellow, is an assistant professor at the Iranian National Center of Addiction Studies (INCAS) and director of Family and Sexual Health Division at the Brain & Spinal cord Injury research Centre (BASIR), Imam Khomeini Hospital Complex, at the Tehran University of Medical Sciences, Tehran, Iran.