Background Genito-pelvic pain/penetration disorder, which consists of a combination of vaginismus and dyspareunia, is considered a new diagnosis in the latest version of the Diagnostic and Statistical Manual of Mental Disorders. Although the etiology of this diagnosis is not well known, a history of abuse has been suggested to be a primary factor in the emergence of this disorder. Aim This systematic review and meta-analysis aimed to determine the association of abuse history with vaginismus and dyspareunia diagnosis. Methods Related keywords were used to search articles in PubMed, PsycArticles, PsycINFO, Scopus, Web of Science, and the Turkish scientific information database (TRDizin). All articles published in English and Turkish until August 2020 were systematically reviewed. A total of 14 case-control studies, including 1428 participants, were included in the final analysis. The fixed-effects model was used to pool odd ratios (ORs) and 95% confidence intervals (CIs) of the studies. Heterogeneity was evaluated using the I2 statistic. Outcomes Case-control studies that reported vaginismus or dyspareunia outcomes in individuals with or without a history of abuse. RESULTS A significant relationship was found between a history of sexual (1.55 OR; 95% CI, 1.14–2.10; 12 studies) and emotional abuse (1.89 OR; 95% CI, 1.24–2.88; 3 studies) and the diagnosis of vaginismus. A significant relationship was found between sexual abuse and dyspareunia (1.53 OR; 95% CI, 1.03–2.27; 6 studies). No statistically significant relationship was observed between physical abuse, vaginismus, and dyspareunia. No significant difference was found between sexual or physical abuse in terms of assessment methods for the diagnosis of vaginismus and dyspareunia. Clinical Implications This systematic review and meta-analysis points out that in the assessment of vaginismus patients, the risk of sexual and emotional abuse and in the assessment for dyspareunia patients, the risk of sexual abuse should be questioned and addressed in its treatment. Strenght and Limitations The strength of the current meta-analysis is the inclusion of all forms of abuse, and studies published in Turkish and English with a broad and reproducible search strategy. The limitations of this meta-analysis are the exclusion of sources and design other than journal articles and case-control studies, including studies both childhood and adult abuse, which in some studies were not differentiated, having potential language and recall bias. CONCLUSION The study analysis suggests an association of vaginismus with sexual and emotional abuse and dyspareunia with sexual abuse. However, both disorders showed no association with physical abuse.

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Objective The mental, physical and sexual health of women as well as maternal and fetal health should be considered during the prenatal and postnatal periods. Investigating the effect of clinical Pilates exercises and prenatal education (CPE & PE) on obstetric and neonatal outcomes as well as the mental, physical, and sexual health of women was intended. Methods In the second trimester, mothers with singleton pregnancies who attended (n=79, study group) or did not attend (n=80, control group) CPE & PR were recruited to this prospective cohort study, and were evaluated in the prenatal and postnatal periods. Depression was assessed with Beck Depression Inventory (BDI), sexual functions with Female Sexual Function Index (FSFI), muscle strength with Gross Muscle Scales (GMS), and labor pain with Visual Analogue Scale (VAS). In addition, the presence of low back pain (LBP) was questioned. Results No significant association of CPE & PE with obstetric outcomes such as cesarean rates, preterm birth, and neonatal outcomes such as birth weight and Apgar scores were identified. Changes in VAS scores, the incidence of perineal trauma, and episiotomy were not associated with CPE & PE. However, CPE & PE was associated with lower BDI scores, a gradual increase in the total scores of FSFI, increased GMS, and reduced LBP. Conclusion CPE & PE had no adverse effects on obstetric and neonatal outcomes and was associated with improved mental, physical, sexual health scores during pregnancy and postpartum.

Background Vaginismus has an unknown etiology, is comorbid with anxiety, and is the most common sexual dysfunction in sexual dysfunction outpatient clinics in Turkey. Aim This study aimed to determine the frequency of adult separation anxiety disorder (ASAD) and styles of attachment in patients with vaginismus and to investigate its relationship with female sexual dysfunction. Methods Sixty women with vaginismus and 60 healthy controls were compared using the Relationship Scales Questionnaire, Female Sexual Function Index (FSFI), and Adult Separation Anxiety Questionnaire (ASA-27). Outcomes We report the results of the questionnaires with their implication on the etiology of vaginismus. RESULTS Separation anxiety and fearful and dismissive avoidance attachment style in the vaginismus group were significantly higher than in the control group. Both total FSFI scores and arousal, pain, and satisfaction subscale scores were higher in the control group. Clinical Implications ASAD should be evaluated and addressed separately, when necessary, in the treatment of vaginismus. Strengths & Limitations The relationship between ASAD and vaginismus has been shown for the first time. Study limitations included the assessment of factors influencing the study results based on self-reporting and possible recall bias. CONCLUSION Attachment and comorbidity research in vaginismus needs to shift from just reporting disturbances, to identify various clinical variables, such as the severity of the vaginismus, response to therapy, and differences in therapeutic modalities, in terms of outcome.

Cinsel saldırılar sıklıkla kadınları hedef almakta, diğer şiddet formları ile birlikte görülmekte, mağdurlarda fiziksel yaralanmalara ve psikolojik örselenmeye yol açabilmektedir. Cinsel saldırı mağdurlarının önemli bir kısmı adli bildirim yapmamakta, bildirim yapanlar ise delillerin toplanması için gereken kritik süreyi aşmaktadır. Alanyazında bu durumun cinsel şiddetle ilgili yanlış inanışlar, damgalanma, yakın ilişki içinde rıza dışı cinsel ilişkilerin şiddet olarak algılanmaması ve adli muayenenin travmayı hatırlatıcı etkisi ile ilişkili olduğu belirtilmiştir. Adli bildirim sonrasında hayatını nasıl planlayacağıyla ilgili bilinmezlikler mağdurun yardım arama davranışını etkileyen bir başka faktördür. Bu derlemede cinsel saldırı durumunda psikolojik ilkyardımın amacı, zamanlaması ve müdahalenin aşamaları ele alınmıştır. Psikolojik ilkyardım kısa vadede mağdurun güvenlik ihtiyacı ve olumsuz duygularını ele almayı, yardım almaya hazır hissettiğinde ulaşabileceği kaynakların varlığıyla ilgili bilgilendirmeyi hedeflemektedir. Uzun vadede ise mağdurdaki psikolojik örselenmeyi azaltmaya yardımcı olmaktadır. Müdahale mağdurla ilişkinin kurulması, problemlerin tanımlanması, duyguların ele alınması, alternatiflerin keşfedilmesi, eylem planının geliştirilmesi ve takip aşamalarından oluşmaktadır. Psikolojik ilkyardım sadece sağlık çalışanı-hasta kooperasyonunu sağlayarak delillerin sağlıklı bir şekilde toplanmasını sağlamakla kalmaz aynı zamanda mağdurun güvenlik planının hazırlanmasına ve duygusal örselenmesinin azaltmasına da katkı sağlamaktadır.