Vaginismus and Dyspareunia: Relationship with General and Sex-Related Moral Standards

Vaginismus is a common condition seen in a psychosexual clinic.  The psychosexual doctor works with the patient to help them understand how their mind may be influencing their body, in order to improve the condition.  This may be coupled with behavioural techniques and exercises to reduce pelvic muscle spasm and anxiety around penetration. 

This study aims to look at whether the attitudes the patient brings into the surgery, particularly conservative morals and strict sexual standards are important in the condition. 

The study consisted of three groups; a primary vaginismus group containing 24 patients, a dyspareunia group also of 24 patients and a group of 32 healthy women not complaining of sexual problems.  The mean ages for each group were 30.1, 28.8 and 29.5 respectively.

Each woman gave a sexual history and underwent examination.  The dyspareunia group included women with provoked vestibulodynia, lichen sclerosus, recurrent candidiasis and endometriosis.

Each woman answered the Golombok Rust Inventory of Sexual Satisfaction (GRISS) questionnaire the Schwartz Value Survey (SVS) to assess moral values and the Sexual Disgust Questionnaire (SDQ) to measure their specific sexual attitudes.

Not surprisingly the vaginismus group scored lowest on the sexual satisfaction (GRISS) score with the healthy group reporting most satisfaction, the dyspareunia group were inbetween and the differences between the groups were statistically significant.

On the SVS, women with vaginismus reported low scores on liberal values and high scores on conservative values.  The values were not significantly different between the dyspareunia and healthy group. In terms of sexual willingness, the SDQ value was lower again for those with vaginismus. 

This suggests women with vaginismus hold stronger adherence to conservative moral values than women without sexual problems.

The definitive aetiology of vaginismus is still unknown but many factors have been implemented.  There has been a move to define this and dyspareunia as a form of chronic pain syndrome.  While taking a neurophysiological approach has helped identify potential mechanisms and treatments, the context in which the painful vaginal spasms of vaginismus are occurring can’t be ignored.  This study reminds us that the patient’s thoughts, values and early conditioning can have an effect on the condition and it remains important to look at the emotions and feelings that accompany the physical responses.

Borg C, de Jong PJ, Schultz WW. Vaginismus and dyspareunia: relationship with general and sex-related moral standards. J Sex Med 2011; 8: 223-231

 

Filed under: View All, MedicinePosted at 21:56

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