Obstetric outcomes of 297 women treated for vaginismus

The experiences of women seeking help for vaginismus and its impact on their sense of self: An integrative review

BACKGROUND

There is low social awareness of vaginismus despite it being a relatively common female sexual dysfunction that makes vaginal penetration painful, difficult, and/or impossible. While existing literature on vaginismus has had a clinical focus on the affected genitalia, there is a lack of research on women's help-seeking experiences of vaginismus from their perspective.

OBJECTIVES

This integrative review's objective was to explore: women's help-seeking experiences of vaginismus, and how such help-seeking experiences impact their sense of self.

DESIGN

Cooper's five-step integrative review approach was followed to develop a research question, a search strategy, selection criteria, and data evaluation, analysis, and presentation.

DATA SOURCES AND METHODS

A systematic search of the literature was completed in the following seven databases in January 2023: PsycINFO, ProQuest Central, PubMed, Scopus, CINAHL, Cochrane, and Embase. Out of the 373 articles found through database searches and additional citation searching, 22 studies were included in this review for meeting the eligibility criteria of having an empirical design, being written in English, and examining women's help-seeking experiences for vaginismus and its impact on their sense of self.

RESULTS

Thematic analysis was used to summarize the findings from the included studies which were informed by 1671 participants. Help-Seeking Process, Medical Management, Help-Seeking and Sense of Self, and Holistic Care Recommendations from the Findings emerged as four major themes with corresponding subthemes.

CONCLUSION

This review indicates that women continue to face difficulties in seeking and receiving help for vaginismus even through the healthcare system. However, the studies did not explicitly discuss how women's help-seeking for vaginismus impacted their sense of self. This highlights an epistemological gap on how women's help-seeking for their vaginismus impacts their sense of self, which can affect their treatment responses. Recommendations are provided for future healthcare and research to improve health outcomes for women with vaginismus.

The Impact of the COVID-19 Pandemic and Social Isolation on the Sexual Functioning of Women Who Have Been Treated for Vaginismus

Background: Multiple factors that impact the mental and hormonal condition of the person influence female sexual function. To our knowledge, however, hardly any research has investigated the sexual function during the COVID-19 pandemic for women who were treated for vaginismus.

Aim: The purpose of this research is to examine how sexual function, frequency of sexual activity, and dyspareunia altered in women who had been treated for vaginismus before the pandemic.

Methods: This observational study ultimately included 204 patients with completely treated vaginismus at the Women's Health Clinic . Before and during the pandemic, the following data was collected: age, education level, profession, frequency of sexual activity, Arizona Sexual Experiences Scale (ASEX) scores, Golombok-Rust Inventory of Sexual Satisfaction (GRISS) scores, and Hamilton Depression Rating Scale (HDRS) scores.

Results: Before the pandemic, the mean ASEX score of women in the research group was 12.56±3.41 , and during the pandemic, ASEX average scores of the women significantly increased to 16.88±5.56 . The GRISS total scores were 28.7±10.1 (range, 14-50) following therapy and 23.9±14.8 (8-58) during the pandemic. After therapy, the HDRS score was 9.58±5.53 (1-19) , while it was 15.21±6.43 (5-26) during the pandemic. During the coronavirus disease 2019 (COVID-19) pandemic, mental health declined significantly, indicating a mild state of depression unrelated to vaginismus. During the pandemic, the mean frequency of sexual activity was 2.9±1.4 per week, and the frequency of sexual encounters did not considerably vary.

Clinical Implications: Therapists should examine the pandemic's impacts on all sexual function symptom categories and modify their treatment plans appropriately. The findings indicate that lowering COVID-19-related stress may be especially useful in minimizing the negative impact of COVID-19 on symptoms. We noticed that vaginismus-treated women did not relapse during the pandemic.

Limitations: The study population was comprised of women attending a particular women health clinic. This can place a certain bias on the demography of the patient population.

Conclusion: The present research indicated that the frequency of sexual activity among women treated for vaginismus did not alter, and notwithstanding a rise in stress and depression ratings, the majority of sexual function scores, including pain, improved during the pandemic. Nonetheless, dissatisfaction and anorgasmia subscales deteriorated, while ASEX satisfaction did not improve to the same extent, suggesting deleterious consequences on sexual function.