Indian journal of psychiatry · 2025
Interdisciplinary management of vaginismus: Case series on psycho-behavioral interventions by mental health and gynecological teams.
СтатьяНазвание и аннотация: Перевод в очереди
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Sahoo Swapnajeet, Koner Shreyashi, Arora Aashima, Joshi Bharti, Mishra Eepsita, Grover Sandeep
Аннотация
BACKGROUND: Vaginismus, categorized under ICD-11 as a sexual pain-penetration disorder, is often overlooked in clinical practice, particularly in culturally conservative societies where stigma, lack of awareness, and gendered misconceptions delay help-seeking. This case series examines the interdisciplinary management of vaginismus.
CASES: Five women (ages 22-35) with lifelong or acquired vaginismus, diverse comorbidities (e.g., dysthymia, childhood trauma, infertility distress), and delayed help-seeking due to the sociocultural barriers were managed through an interdisciplinary model. Gynecological assessments ruled out organic causes, followed by psychiatric evaluation, and tailored interventions: pharmacotherapy (Selective serotonin reuptake inhibitors (SSRIs), duloxetine, propranolol), psychoeducation, cognitive-behavioral techniques (Jacobson's relaxation, sensate focus), and vaginal dilator therapy. Joint sessions with spouses and graded desensitization were emphasized. Outcomes were tracked over 3-8 months. All patients achieved successful penetrative intercourse and reported improved psychological well-being. Key facilitators included spousal support, trauma-informed therapy, and combined psychiatric-gynecological care. Interventions reduced anticipatory anxiety, resolved pelvic floor dysfunction, and restored marital harmony. Two patients conceived post-treatment.
CONCLUSION: Interdisciplinary collaboration between mental health and gynecological teams is critical for managing vaginismus, particularly in low- and middle-income countries (LMICs) where stigma delays care. The case series highlights the need for enhanced training of gynecologists and mental health professionals to recognize and manage vaginismus as a treatable disorder rather than a taboo subject. This patient series adds to the limited literature on vaginismus from LMICs and serves as an educational resource for clinicians and trainees encountering female sexual dysfunctions in similar sociocultural settings.
CASES: Five women (ages 22-35) with lifelong or acquired vaginismus, diverse comorbidities (e.g., dysthymia, childhood trauma, infertility distress), and delayed help-seeking due to the sociocultural barriers were managed through an interdisciplinary model. Gynecological assessments ruled out organic causes, followed by psychiatric evaluation, and tailored interventions: pharmacotherapy (Selective serotonin reuptake inhibitors (SSRIs), duloxetine, propranolol), psychoeducation, cognitive-behavioral techniques (Jacobson's relaxation, sensate focus), and vaginal dilator therapy. Joint sessions with spouses and graded desensitization were emphasized. Outcomes were tracked over 3-8 months. All patients achieved successful penetrative intercourse and reported improved psychological well-being. Key facilitators included spousal support, trauma-informed therapy, and combined psychiatric-gynecological care. Interventions reduced anticipatory anxiety, resolved pelvic floor dysfunction, and restored marital harmony. Two patients conceived post-treatment.
CONCLUSION: Interdisciplinary collaboration between mental health and gynecological teams is critical for managing vaginismus, particularly in low- and middle-income countries (LMICs) where stigma delays care. The case series highlights the need for enhanced training of gynecologists and mental health professionals to recognize and manage vaginismus as a treatable disorder rather than a taboo subject. This patient series adds to the limited literature on vaginismus from LMICs and serves as an educational resource for clinicians and trainees encountering female sexual dysfunctions in similar sociocultural settings.