Scolaris Content Display Scolaris Content Display

Intervencije za vaginizam

Collapse all Expand all

Abstract

Background

Vaginismus is an involuntary contraction of the vaginal muscles which makes sexual intercourse difficult or impossible. It is one of the more common female psychosexual problems. Various therapeutic strategies for vaginismus, such as sex therapy and desensitisation, have been proposed, and uncontrolled case series appear promising.

Objectives

To assess the effects of different interventions for vaginismus.

Search methods

We searched the Cochrane Depression, Anxiety and Neurosis Group's Specialised Register (CCDANCTR‐Studies and CCDANCTR‐References) to August 2012. This register contains relevant randomised controlled trials from: The Cochrane Library (all years), EMBASE (1974 to date), MEDLINE (1950 to date) and PsycINFO (1967 to date). We searched reference lists and conference abstracts. We contacted experts in the field regarding unpublished material.

Selection criteria

Controlled trials comparing treatments for vaginismus with another treatment, a placebo treatment, treatment as usual or waiting list control.

Data collection and analysis

The review authors extracted data which we verified with the trial investigator where possible.

Main results

Five studies were included, of which four with a total of 282 participants provided data. No meta‐analysis was possible due to heterogeneity of comparisons within included studies as well as inadequate reporting of data. All studies were considered to be at either moderate or high risk of bias. The results of this systematic review indicate that there is no clinical or statistical difference between systematic desensitisation and any of the control interventions (either waiting list control, systematic desensitisation combined with group therapy or in vitro (with women under instruction by the therapist) desensitisation) for the treatment of vaginismus. The drop‐out rates were higher in the waiting list groups.

Authors' conclusions

A clinically relevant effect of systematic desensitisation when compared with any of the control interventions cannot be ruled out. None of the included trials compared other behaviour therapies (e.g. cognitive behaviour therapy, sex therapy) to pharmacological interventions. The findings are limited by the evidence available and as such conclusions about the efficacy of interventions for the treatment of vaginismus should be drawn cautiously.

Laički sažetak

Postupci za liječenje vaginizma

Vaginizam je naziv za grč mišića vagine koji se javlja prilikom pokušaja bilo kakve vaginalne penetracije (pokušaj spolnog odnosa, umetanje ginekoloških instrumenata, stavljanje tampona ili menstrualnih čašica, itd.), zbog čega spolni odnos može biti bolan ili nemoguć. Vaginizam uzrokuje stres, probleme u vezi i neplodnost. Iskušane su različite vrste terapija za vaginizam, uključujući seksualnu terapiju, edukaciju, hipnozu i lijekove. Seksualna terapija može uključivati metode opuštanja i postupno umetanje dilatatora ili prsta u vaginu (što se ponekad zove sustavna desenzitizacija).

Ovaj Cochrane sustavni pregled našao je 5 studija koje su bile loše ili umjerene metodološke kvalitete, u kojima je bilo uključeno 282 žena. Nije pronađeno dovoljno dokaza da je sustavna desenzitizacija bolja od neke druge vrste liječenja. Buduće studije bi trebale uključiti dovoljan broj žena i istražiti je li sustavna desenzitizacija učinkovita terapija za žene koje pate od vaginizma.