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Lifelong Vaginismus is a “Couple Problem,” Researchers Say

Reviewed by the medical professionals of the ISSM’s Communication Committee

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The affective temperaments of men and women can affect experiences with lifelong vaginismus (LLV), according to new research in the Journal of Sexual Medicine.

“Our findings support the idea that LLV is a ‘couple problem’,” the authors wrote.

Vaginismus is classified as a genito-pelvic pain/penetration disorder (GPPPD).

Symptoms
Women with vaginismus have involuntary muscle spasms at the start of vaginal penetration, causing the vagina to become narrower and tighter. As a result, vaginal intercourse can become quite painful or even impossible. The condition is considered lifelong if it has occurred since a woman’s first sexual experience.

Vaginismus is often linked with depression and anxiety, and it can cause problems with partner relationships. However, little is known about the influence of temperament in couples facing vaginismus.

“Temperament is related to the biological basis of personality and is described as attitudes and behaviors that stand on structural genetic foundations,” the authors explained. “It is heritable and relatively stable throughout life.”

Studies

  • To learn more, the researchers worked with 56 women with LLV (median age 28) and their male partners (median age 30). None of the women had ever had full sexual intercourse. Another group of 44 heterosexual couples, who had no sexual difficulties, served as a control group. Almost all of the couples in both groups were married.
  • The participants completed several questionnaires that assessed sexual satisfaction and symptoms of depression and anxiety.
  • They also completed the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Auto Questionnaire Scale (TEMPS-A) to evaluate affective temperament in each participant. The TEMPS-A covers five domains: depressive, cyclothymic, hyperthymic, irritable, and anxious.
  • Compared to the women in the control group, the women with LLV had higher levels of anxiety and depression. They also had more sexual dysfunction, except for avoidance. On the TEMPS-A assessment, women with LLV had poorer scores in the depressive, anxious, cyclothymic, and irritable temperament domains than the control women did.
  • The researchers found no differences in avoidance between the two groups of women. While women with LLV might avoid vaginal penetration, they may not avoid other sexual activities, the authors explained. Therefore, scores on avoidance could be similar regardless of LLV status.
  • Among the men, those whose partners had LLV had higher anxiety levels and less sexual satisfaction compared to men in the control group. Men in the LLV group also were also more likely to have depressive and cyclothymic temperaments than men in the control group.
  • The data also showed how combinations of temperaments among women with LLV and their male partners might contribute to poorer sexual function. For example, this situation was found in couples in which men with hyperthymic temperaments were partnered with women with anxious and depressive temperaments.
  • In addition, hyperthymic temperament in men had negative effects on women’s sexual function. However, a depressive temperament in men had a positive effect on women’s sexual function.

Clinicians who treat women with LLV might consider the way individual characteristics come into play for both men and women, they suggested.

They recommended more research on male partners of women with LLV.


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