Prognostic variables in treating vaginismus.

Twenty-three patients with vaginismus were seen in a Sexual Dysfunction Program over five years. Twenty of these patients continued in therapy and had successful outcomes. Length of therapy was analyzed and seen to be related to the following factors: duration of the dysfunction, and patient's conception of the etiology of the problem, history of previous attempts at operative treatment, motivational factors, the husband's degree of acceptance of the unconsummated marriage, previous organic abnormalities, extent of sexual knowledge, fear of sexually transmitted diseases, parental attitudes regarding sex, and the patient's attitude toward her genitalia. Follow-up of one to four years has revealed maintenance of sexual functioning in 95% of the couples. The three patients who dropped out and were considered failures all had had previous operative therapy and would not relinquish the idea that there was an anatomic abnormality causing their dysfunction. The method of therapy is reviewed.