Treatment of vaginismus: A review of concepts and treatment modalities

Abstract

In this study, the literature on the concept of vaginismus is reviewed as well as existing ideas about etiology and treatment. The review reveals that consensus only exists on the physiological aspects of vaginismus, whereas a great variety of ideas and opinions are used with regard to the etiology and treatment of this sexual problem. The most recent approaches are the psychoanalytical view, the behavioristic view, the interactional view and the sociocultural view. The study also comprises a review of the Anglo-Saxon literature on the outcome of treatment of vaginismus. Over the last three decades, 37 studies have been published: 17 case studies and 20 survey studies. The review makes it clear that vaginismus is usually treated successfully and that the kind of treatment does not seem to play an important role in this. All treatment modalities report a success rate of about 80%. Differences, however, do exist regarding the therapeutic goals and cost-benefit ratios. Before drawing any firm conclusions, it has to be mentioned that the review also revealed that hardly any of the publications investigated, met even the most basic methodological demands. It is therefore concluded that well designed and controlled studies on the treatment of vaginismus should be conducted in the near future.