Validation of the partner version of the multidimensional vaginal penetration disorder questionnaire: A tool for clinical assessment of lifelong vaginismus in a sample of Iranian population

Psychometric Properties of the Translated Spanish Version of the Vaginal Penetration Cognition Questionnaire: A Preliminary Work for Validation

(1) Background: To develop an instrument in Spanish to assess beliefs and feelings about vaginal penetration and assess its psychometric properties. (2) Methods: This study translated and adapted the Vaginal Penetration Cognition Questionnaire into Spanish, and a total of 225 women who suffered from Genito-Pelvic Pain/Penetration Disorder were included in the study. The psychometric properties, including construct, convergent and discriminant validity, test-retest reliability, and internal consistency of the translated version were assessed. (3) Results: The Spanish version of the Vaginal Penetration Cognition Questionnaire is a valid, reliable, and consistent tool to assess beliefs and thoughts about vaginal penetration in women suffering from Genito-Pelvic Pain/Penetration Disorder. The exploratory factor analysis yielded four domains that explained 62.5% of the variance. Convergent and discriminant validity was also confirmed. Test-retest reliability was high, with an intraclass correlation coefficient value of 0.90, a standard error of measurement of 4.21, and a minimal detectable change of 11.66 points. Every domain also showed good internal consistency levels, with Cronbach's α values ranging from 0.84 to 0.89. (4) Conclusion: The Spanish version of the Vaginal Penetration Cognition Questionnaire is a valid, reliable, and consistent tool to assess vaginal penetration cognition in women suffering from Genito-Pelvic Pain/Penetration Disorder.

Comparative Study of 150 vs. 200 Units of Botulinum Toxin as Treatment for Vaginismus

OBJECTIVE

 To comparatively evaluate the outcome of treatment with 150 versus 200 units (U) of botulinum toxin in achieving pain-free intercourse and relieving muscle contraction in order to allow gynecological examination.

METHODS

 In this comparative prospective observational study, 99 patients with vaginismus were treated with botulinum toxin injections from September 2016 to August 2021. Diagnosis and grading of vaginismus severity were assessed using a Female Sexual Function Index (FSFI) questionnaire. Under local or general anesthesia, botulinum toxin diluted with preservative-free saline (150 U and 200 U) was injected into, above, and below the right and left bulbospongiosus muscle and the lateral submucosal areas of the introitus and perineal body using an insulin syringe. Patients were recalled after 2 weeks, and the postoperative outcome was recorded using a similar preoperative questionnaire.

RESULTS

 Overall, the mean age of patients was 30.2 years. The baseline and clinical characteristics were comparable between the 2 groups (p > 0.05). Significant improvements were seen in the pain and anxiety scores of finger penetration, dilator use, intercourse, and cotton swab in individual groups. The intergroup comparisons between 150 U and 200 U of Botox were not statistically significant (p > 0.05).

CONCLUSION

 Low-dose Botox (150 U) is equally effective as high dose Botox injections (200 U) in vaginismus patients. Therefore, Botox-150 U can be used to treat vaginismus as an alternative to high doses of the same substance.

Determining the frequency of Candida species in women with candidal vaginal infection frequency of Candida species in women with candida vaginal infection

BACKGROUND

Candidiasis vaginitis is an opportunistic and common mucosal infection. Although Candida albicans is the most common isolated species, other species of Candida such as Candida glabrata, Candida krusei, Candida parapsilosis, and Candida tropicalis have also increased significantly in recent years. The aim of this study was to identify Candida species in women with candidal vaginal infection in order to promote health in women.

MATERIALS AND METHODS

This cross-sectional descriptive study was performed on nonpregnant women of childbearing age who referred to health centers in Neyshabur in 2018. At the beginning of the study, 163 people entered the study and the culture results were positive in 68 of them. In vitro, culture was performed in subduxtrose agar medium containing chloramphenicol and gentamicin. Species identification was performed using Candida specific culture medium (Saburo dextrose agar and chloramphenicol). After culture, 15% of the residual wet slide with potash (KOH) was prepared and observed with a lens. Finally, the data were analyzed with SPSS software version 24.

RESULTS

The participants in the study were women with a mean age of 35.55 ± 5.47 and the average number of deliveries was 1.38 ± 1.15. In this study, the prevalence of C. albicans was 59.7%, C. tropicalis was 14.8%, C. krusei was 15%, and C. glabrata was 7.61% and also krusei and tropicalis were 3% simultaneously. Therefore, C. albicans was the most common species isolated from clinical specimens.

CONCLUSION

In this study, the most common species after albicans were C. tropicalis and cruciferous. Considering the role of C. glabrata in the development of resistance to antifungal drugs, the lower prevalence of this species in the present study can be associated with improved treatment outcomes in patients.

Levels of Depression and Anxiety, Sexual Functions, and Affective Temperaments in Women With Lifelong Vaginismus and Their Male Partners

BACKGROUND

Depression and anxiety levels, sexual dysfunctions, and affective temperament characteristics of women with lifelong vaginismus (LLV) and their male partners may have important effects on the development, maintenance, and exacerbation of LLV.

AIM

We aimed to investigate depression and anxiety levels, sexual dysfunctions, and affective temperament characteristics of both women with LLV and their male partners.

METHODS

56 women with LLV, their 56 male partners, and 44 couples with no complaints of any sexual function as a control group were included in this study. Dyadic data were analyzed using the Actor-Partner Interdependence Model.

OUTCOMES

The Beck Depression Inventory, Beck Anxiety Inventory, Golombok Rust Inventory of Sexual Satisfaction, and Temperament Evaluation of Memphis, Pisa, Paris and San Diego Auto Questionnaire Scale were completed by all participants.

RESULTS

Women with LLV had higher levels of anxiety and depression and had more sexual dysfunctions except for avoidance than those of female controls. Temperament Evaluation of Memphis, Pisa, Paris and San Diego Auto Questionnaire Scale scores were significantly higher in women with LLV for depressive (odds ratio [OR] = 1.27, 95% CI = 1.09-1.49), cyclothymic (OR = 1.31, 95% CI = 1.15-1.49), anxious (OR = 1.22, 95% CI = 1.09-1.38), and irritable (OR = 1.22, 95% CI = 1.04-1.42) temperament than in female controls. It was found that anxiety levels of male partners of women with LLV were higher than those of male controls and that they experienced less sexual satisfaction. Depressive (OR = 1.31, 95% CI = 1.07-1.61) and cyclothymic (OR = 1.18, 95% CI = 1.04-1.34) temperament scores were significantly higher in male partners of women with LLV than in male controls. The Actor-Partner Interdependence Model analyses show that hyperthymic temperament in male partners of women with LLV and anxious and depressive temperament in women with LLV have a negative effect on their own sexual functions. In terms of partner effect, it was found that men with hyperthymic temperament had a negative effect on the sexual functions of women with LLV and men with depressive temperament had a positive effect.

CLINICAL IMPLICATIONS

The individual characteristics of both the women and their male partners have an impact on LLV.

STRENGTHS & LIMITATIONS

The sample size was relatively small to assess affective temperaments. The inclusion of male partners in the study contributed to our understanding of couples with LLV.

CONCLUSION

Our results indicate that affective temperaments detected in women with LLV (depressive, cyclothymic, anxious and irritable) and their male partners (depressive and cyclothymic) have an effect on the development, maintenance, and exacerbation of LLV, and affective temperaments have an effect on both their own and partner's sexual functions. Turan Ş, Usta Sağlam NG, Bakay H, et al. Levels of Depression and Anxiety, Sexual Functions, and Affective Temperaments in Women With Lifelong Vaginismus and Their Male Partners. J Sex Med 2020;17:2434-2445.

Assessment Scales for Sexual Disorders—A Review

Over the last 3 to 4 decades then has been an upsurge in designing rating instruments for assessing various aspects of sexuality, sexual dysfunction, and sexual disorders. In this article, we review the instruments used for assessing/rating various sexual disorders stemming from problems in the areas of sexual knowledge to erection/ejaculation to marital functioning, etc. Some of the available scales focus on all the phases of the sexual cycle, whereas other scales focus on the specific phases of the sexual cycle. Some of the commonly used scales, which assess multiple domains of sexual dysfunction include the Arizona Sexual Experience Scale or the International Index of Erectile Dysfunction. Some of the scales focus on other disorders such as Dhat syndrome. Though a lot of scales are available, there is a paucity of culturally sensitive, translated-validated scales. Although rating instruments provide us with valuable information about the sexual functioning of an individual, these should always be used as an add-on, ie, secondary to detailed taking and clinical examination for making any diagnosis or formulation of a management plan.

Psychosocial Correlates of Vaginismus Diagnosis: A Case-Control Study

The objective of this case-control study was to identify psychosocial factors associated with vaginismus. One hundred twenty women were recruited and interviewed at the Institute of Human Sexuality, 40 with lifelong vaginismus, and 80 controls without vaginismus. Participants were matched for age, education, and date of admission. Women afraid of losing control during intercourse had 29.6 times greater likelihood of developing vaginismus (p < 0.01), as well as those afraid of suffering pain (p < 0.001) or being physically damaged (tearing) (p < 0.01). There is evidence that women have higher likelihood of vaginismus if they present fears of pain, injuries, bleeding, fear of losing control, and having a panic attack if they engage in sex with penetration.