Abstract
Introduction: Vaginismus includes some psychological conditions such as fear of pain and avoidance from penetration. There is little knowledge about the effects of vaginismus.
Objective: The present study aims to present the bio-psychosocial consequences of vaginismus in women life. Methods: The method of the present study is a review, which is conducted on the available resources. All relevant studies were included to present effects of vaginismus on the women. Results: Women who have vaginismus have many problems with self-identity, psychological and reproductive lives. Most of the effects of vaginismus lead to another deep effect on women. Women with vaginismus mostly describe themselves negatively. This negative self-perception affects women’s self-esteem levels which cause psychiatric disorders. The psychiatric disorders have been associated with vaginismus as a reason and result. It is stated in the studies that the general anxiety and, penetration specific anxiety are related to vaginismus. This result reflects that women with vaginismus have more anxiety about penetration. Women with vaginismus encounter reproductive problems, who are more likely to encounter increased cesarean section and fertility problems, they are reluctant to seek health care services, especially due to fear of the gynaecological examination. Conclusion: Although vaginismus is a common problem, there is little information about the effects of vaginismus on women. Vaginismus causes psychiatric disorders and reproductive problems. The researchers should examine how women live with vaginismus. It is also suggested that psychotherapy techniques should include couples interventions and, researchers should examine psychological health of women deeply.Keywords: Vaginismus, psychological effects, psychotherapies, pregnancy, birth, gynaecological examination.
Graphical Abstract
[1]
American Psychological Association. Diagnostic and statistical manual of mental disorders (DSM-5®). Philadelphia: American Psychiatric Publishers 2013.
[2]
Goldsmith T, Levy A, Sheiner E, Goldsmith T, Levy A, Sheiner E. Vaginismus as an independent risk factor for cesarean delivery. J Matern Fetal Neonatal Med 2009; 22(10): 863-6.
[http://dx.doi.org/10.1080/14767050902994598] [PMID: 19701866]
[http://dx.doi.org/10.1080/14767050902994598] [PMID: 19701866]
[3]
Binik YM. The DSM diagnostic criteria for vaginismus. Arch Sex Behav 2010; 39(2): 278-91.
[http://dx.doi.org/10.1007/s10508-009-9560-0] [PMID: 19851855]
[http://dx.doi.org/10.1007/s10508-009-9560-0] [PMID: 19851855]
[4]
Bokaie M, Bostani Khalesi Z. Couple therapy and vaginismus: A single case approach. J Sex Marital Ther 2019; 45(8): 1-7.
[5]
Semnani Y, Razzaghizadeh B. Management of an unconsummated marriage after 14 years. J Qazvin Uni Med Sci 2003; 28: 89-92.
[6]
Demir O, Comba C. Treatment of a woman with seconder infertility and vaginismus. Med Sci 2019; 23(96): 195-200.
[7]
Lahaie MA, Boyer SC, Amsel R, Khalifé S, Binik YM. Vaginismus: a review of the literature on the classification/diagnosis, etiology and treatment. Womens Health (Lond) 2010; 6(5): 705-19.
[http://dx.doi.org/10.2217/WHE.10.46] [PMID: 20887170]
[http://dx.doi.org/10.2217/WHE.10.46] [PMID: 20887170]
[8]
Pacik PT. Understanding and treating vaginismus: a multimodal approach. Int Urogynecol J Pelvic Floor Dysfunct 2014; 25(12): 1613-20.
[http://dx.doi.org/10.1007/s00192-014-2421-y] [PMID: 24894201]
[http://dx.doi.org/10.1007/s00192-014-2421-y] [PMID: 24894201]
[9]
Bond KS, Weerakoon P, Shuttleworth R. A literature review on vulvodynia and distress. Sex Relationship Ther 2012; 27(1): 46-62.
[http://dx.doi.org/10.1080/14681994.2012.664272]
[http://dx.doi.org/10.1080/14681994.2012.664272]
[10]
Pacik PT, Cole JB. When sex seems impossible: stories of vaginismus & how you can achieve intimacy. Manchester: Odyne Publishing 2010.
[11]
Maseroli E, Scavello I, Cipriani S, et al. Psychobiological correlates of vaginismus: an exploratory analysis. J Sex Med 2017; 14(11): 1392-402.
[http://dx.doi.org/10.1016/j.jsxm.2017.09.015] [PMID: 29110807]
[http://dx.doi.org/10.1016/j.jsxm.2017.09.015] [PMID: 29110807]
[12]
Fadul R, Garcia R, Zapata-Boluda R, et al. Psychosocial correlates of vaginismus diagnosis: a case-control study. J Sex Marital Ther 2019; 45(1): 73-83.
[http://dx.doi.org/10.1080/0092623X.2018.1484401] [PMID: 30044690]
[http://dx.doi.org/10.1080/0092623X.2018.1484401] [PMID: 30044690]
[13]
Pacik PT. Understanding and treating vaginismus: a multimodal approach. Int Urogynecol J Pelvic Floor Dysfunct 2014; 25(12): 1613-20.
[http://dx.doi.org/10.1007/s00192-014-2421-y] [PMID: 24894201]
[http://dx.doi.org/10.1007/s00192-014-2421-y] [PMID: 24894201]
[14]
Basson R, Wierman ME, van Lankveld J, Brotto L. Summary of the recommendations on sexual dysfunctions in women. J Sex Med 2010; 7(1 Pt 2): 314-26.
[http://dx.doi.org/10.1111/j.1743-6109.2009.01617.x] [PMID: 20092441]
[http://dx.doi.org/10.1111/j.1743-6109.2009.01617.x] [PMID: 20092441]
[15]
Johnston SL. Women’s experiences of vaginismus and its treatment: an interpretative phenomenological analysis. Leicester: University of Leicester 2013.
[16]
Dağ H, Dönmez S, Kavlak O. Kadın cinselliğinin gizlenen yönü: Vajinismus ve hemşirenin rolü. Sürekli Tıp Eğitimi Dergisi 2012; 21(5): 43-7.
[17]
Elmerstig E, Wijma B, Berterö C. Why do young women continue to have sexual intercourse despite pain? J Adolesc Health 2008; 43(4): 357-63.
[http://dx.doi.org/10.1016/j.jadohealth.2008.02.011] [PMID: 18809133]
[http://dx.doi.org/10.1016/j.jadohealth.2008.02.011] [PMID: 18809133]
[18]
Duman NB, Koçak DY. İnfertilitenin cinsel sağlığa etkileri ve profesyonel hemşirelik yaklaşımları. Turkiye Klinikleri J Obstet Womens Health Dis Nurs Special Topics 2016; 2(1): 51-8.
[19]
Alden LE, Mellings TMB, Ryder AG. In: Crozier WR, Ed.. The Essential Handbook of Social Anxiety for Clinicians. Needham Hill, MA: Allyn & Bacon 2001; pp. 32-56.
[20]
Achour R, Koch M, Zgueb Y, Ouali U, Ben Hmid R. Vaginismus and pregnancy: epidemiological profile and management difficulties. Psychol Res Behav Manag 2019; 12: 137-43.
[http://dx.doi.org/10.2147/PRBM.S186950] [PMID: 30881157]
[http://dx.doi.org/10.2147/PRBM.S186950] [PMID: 30881157]
[21]
Ward E, Ogden J. Commentary on experiencing vaginismus: sufferers’ beliefs about causes and effects. Sex Relationship Ther 2010; 25(4): 429-33.
[http://dx.doi.org/10.1080/14681994.2010.511644]
[http://dx.doi.org/10.1080/14681994.2010.511644]
[22]
Möller L, Josefsson A, Bladh M, Lilliecreutz C, Sydsjö G. Reproduction and mode of delivery in women with vaginismus or localised provoked vestibulodynia: a Swedish register-based study. BJOG 2015; 122(3): 329-34.
[http://dx.doi.org/10.1111/1471-0528.12946] [PMID: 24990073]
[http://dx.doi.org/10.1111/1471-0528.12946] [PMID: 24990073]
[23]
Borg C, Peters ML, Schultz WW, de Jong PJ. Vaginismus: heightened harm avoidance and pain catastrophizing cognitions. J Sex Med 2012; 9(2): 558-67.
[http://dx.doi.org/10.1111/j.1743-6109.2011.02535.x] [PMID: 22024378]
[http://dx.doi.org/10.1111/j.1743-6109.2011.02535.x] [PMID: 22024378]
[24]
Ciocca G, Limoncin E, Di Tommaso S, et al. Alexithymia and vaginismus: a preliminary correlation perspective. Int J Impot Res 2013; 25(3): 113-6.
[http://dx.doi.org/10.1038/ijir.2013.5] [PMID: 23466663]
[http://dx.doi.org/10.1038/ijir.2013.5] [PMID: 23466663]
[25]
Farnam F, Janghorbani M, Merghati-Khoei E, Raisi F. Vaginismus and its correlates in an Iranian clinical sample. Int J Impot Res 2014; 26(6): 230-4.
[http://dx.doi.org/10.1038/ijir.2014.16] [PMID: 24830673]
[http://dx.doi.org/10.1038/ijir.2014.16] [PMID: 24830673]
[26]
Cherner RA, Reissing ED. A comparative study of sexual function, behavior, and cognitions of women with lifelong vaginismus. Arch Sex Behav 2013; 42(8): 1605-14.
[http://dx.doi.org/10.1007/s10508-013-0111-3] [PMID: 23733151]
[http://dx.doi.org/10.1007/s10508-013-0111-3] [PMID: 23733151]
[27]
Watts G, Nettle D. The role of anxiety in vaginismus: a case-control study. J Sex Med 2010; 7(1 Pt 1): 143-8.
[http://dx.doi.org/10.1111/j.1743-6109.2009.01365.x] [PMID: 19549090]
[http://dx.doi.org/10.1111/j.1743-6109.2009.01365.x] [PMID: 19549090]
[28]
Karagüzel EÖ, Arslan FC, Tiryaki A, Osmanağaoğlu MA, Kaygusuz EŞ. Sociodemographic features, depression and anxiety in women with life-long vaginismus. Anatolian J Psychiatry 2016; 17(6): 489-95.
[http://dx.doi.org/10.5455/apd.215372]
[http://dx.doi.org/10.5455/apd.215372]
[29]
Yıldırım EA, Hacıoğlu Yıldırım M, Karaş H. Prevalence of depression and anxiety disorders and their relationship with sexual functions in women diagnosed with lifelong vaginismus. Turk Psikiyatr Derg 2019; 30(1): 9-15.
[PMID: 31170302]
[PMID: 31170302]
[30]
Kaya B, Unal S, Ozenli Y, Gursoy N, Tekiner S. Anxiety, depression and sexual dysfunction in women with chronic pelvic pain. Sex Relationship Ther 2006; 21: 187-96.
[http://dx.doi.org/10.1080/14681990500359897]
[http://dx.doi.org/10.1080/14681990500359897]
[31]
Betrán AP, Torloni MR, Zhang J-J, Gülmezoglu AM. WHO Working Group on Caesarean Section. WHO statement on caesarean section rates. BJOG 2016; 123(5): 667-70.
[http://dx.doi.org/10.1111/1471-0528.13526] [PMID: 26681211]
[http://dx.doi.org/10.1111/1471-0528.13526] [PMID: 26681211]
[32]
Rosenbaum TY, Padoa A. Managing pregnancy and delivery in women with sexual pain disorders. J Sex Med 2012; 9(7): 1726-35.
[http://dx.doi.org/10.1111/j.1743-6109.2012.02811.x] [PMID: 22759362]
[http://dx.doi.org/10.1111/j.1743-6109.2012.02811.x] [PMID: 22759362]
[33]
World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience. World Health Organization 2016.
[34]
Respress E, Jolly P, Osia C, Williams N, Sakhuja S. A cross-sectional study of antenatal care attendance among pregnant women in W and J. J Pregnancy Child Health 2017; 4(341): 2.
[35]
Daşıkan Z, Sevil Ü. Kadınlarda jinekolojik muayeneyi engelleyen psikososyal faktörler. STED 2017; 26(2): 75-83.
[36]
Boyer S, Pukall C. “This hurts too”: Pelvic examination experiences in women with dyspareunia. J Sex Med 2011; 8: 73.
[37]
Akyüz A, Güvenç G, Yavan T, Çetintürk A, Kök G. Kadınların Pap smear yaptırma durumları ile bunu etkileyen faktörlerin belirlenmesi. Gulhane Tip Derg 2006; 48(1): 25-9.
[38]
Colson M-H, Lemaire A, Pinton P, Hamidi K, Klein P. Sexual behaviors and mental perception, satisfaction and expectations of sex life in men and women in France. J Sex Med 2006; 3(1): 121-31.
[http://dx.doi.org/10.1111/j.1743-6109.2005.00166.x] [PMID: 16409225]
[http://dx.doi.org/10.1111/j.1743-6109.2005.00166.x] [PMID: 16409225]
[39]
Keskin U, Coksuer H, Gungor S, Ercan CM, Karasahin KE, Baser I. Differences in prevalence of sexual dysfunction between primary and secondary infertile women. Fertil Steril 2011; 96(5): 1213-7.
[http://dx.doi.org/10.1016/j.fertnstert.2011.08.007] [PMID: 21880311]
[http://dx.doi.org/10.1016/j.fertnstert.2011.08.007] [PMID: 21880311]
[40]
Millheiser LS, Helmer AE, Quintero RB, Westphal LM, Milki AA, Lathi RB. Is infertility a risk factor for female sexual dysfunction? A case-control study. Fertil Steril 2010; 94(6): 2022-5.
[http://dx.doi.org/10.1016/j.fertnstert.2010.01.037] [PMID: 20206929]
[http://dx.doi.org/10.1016/j.fertnstert.2010.01.037] [PMID: 20206929]
[41]
Agustus P, Munivenkatappa M, Prasad P. Sexual functioning, beliefs about sexual functioning and quality of life of women with infertility problems. J Hum Reprod Sci 2017; 10(3): 213-20.
[http://dx.doi.org/10.4103/jhrs.JHRS_137_16] [PMID: 29142451]
[http://dx.doi.org/10.4103/jhrs.JHRS_137_16] [PMID: 29142451]
[42]
Ramezanzadeh F, Aghssa MM, Jafarabadi M, Zayeri F. Alterations of sexual desire and satisfaction in male partners of infertile couples. Fertil Steril 2006; 85(1): 139-43.
[http://dx.doi.org/10.1016/j.fertnstert.2005.07.1285] [PMID: 16412744]
[http://dx.doi.org/10.1016/j.fertnstert.2005.07.1285] [PMID: 16412744]
[43]
Michetti PM, Silvaggi M, Fabrizi A, Tartaglia N, Rossi R, Simonelli C. Unconsummated marriage: can it still be considered a consequence of vaginismus? Int J Impot Res 2014; 26(1): 28-30.
[http://dx.doi.org/10.1038/ijir.2013.24] [PMID: 23698820]
[http://dx.doi.org/10.1038/ijir.2013.24] [PMID: 23698820]
[44]
Badran W, Moamen N, Fahmy I, El-Karaksy A, Abdel-Nasser TM, Ghanem H. Etiological factors of unconsummated marriage. Int J Impot Res 2006; 18(5): 458-63.
[http://dx.doi.org/10.1038/sj.ijir.3901452] [PMID: 16421602]
[http://dx.doi.org/10.1038/sj.ijir.3901452] [PMID: 16421602]
[45]
Bokaie M, Khalesi ZB, Yasini-Ardekani SM. Diagnosis and treatment of unconsummated marriage in an Iranian couple. Afr Health Sci 2017; 17(3): 632-6.
[http://dx.doi.org/10.4314/ahs.v17i3.5] [PMID: 29085390]
[http://dx.doi.org/10.4314/ahs.v17i3.5] [PMID: 29085390]
[46]
Özdemir O, Şimşek F, Ozkardeş S, İncesu C, Karakoç B. The unconsummated marriage: its frequency and clinical characteristics in a sexual dysfunction clinic. J Sex Marital Ther 2008; 34(3): 268-79.
[http://dx.doi.org/10.1080/00926230701866380] [PMID: 18398764]
[http://dx.doi.org/10.1080/00926230701866380] [PMID: 18398764]
[47]
Sutherland O. Qualitative analysis of heterosexual women’s experience of sexual pain and discomfort. J Sex Marital Ther 2012; 38(3): 223-44.
[http://dx.doi.org/10.1080/0092623X.2011.606880] [PMID: 22533868]
[http://dx.doi.org/10.1080/0092623X.2011.606880] [PMID: 22533868]