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Objective

Although Vaginismus (V) is a condition with a great impact on psycho-sexological well-being, the evidence on the efficacy of interventions is lacking. We aimed to review all information on V treatment, including data from RCTs and observational studies.

Methods

Systematic search was conducted of MEDLINE, EMBASE, PsycINFO and ClinicalTrials.gov. Two independent meta-analyses of RCTs and observational studies were performed. For RCTs, only those having no treatment as the comparator were considered eligible. The primary outcome was the success rate (number of successes / total sample) in the completion of sexual intercourse.

Results

43 observational studies (n=1660) and 3 RCTs (n=264) were included in the final analyses, respectively. In the meta-analysis of RCTs, the use of psychological interventions showed a trend towards a significantly better result vs. waiting list control [MH-OR 10.27 (0.79;133.5); p=0.075]. The combination of the Results obtained from the observational studies showed that treating V is associated with the completion of sexual penetrative intercourse in 79% of cases, independently of the therapy used [success rate 0.79 (0.74–0.83)]. When only moderate or strong quality studies were considered, the success rate was 0.82 (0.73-0.89). As for the different definitions of V, studies with unconsummated marriage as the inclusion criterion showed the worst success rate (0.68). Neither the origin of V (primary, secondary or both), its duration, the mean age of the participants, the involvement of the partner in the intervention or the geographic setting exerted a significant effect on the outcome. Studies enrolling women with unconsummated marriage showed a significantly worse success rate.

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