Vaginismus in Assisted Reproductive Technology Centers: an invisible population in need of care

Abstract

ObjectiveGenital and sexual pain is still neglected. Consequences may be dramatic, since infertility and sexual dysfunction may be reciprocally linked. This is the first study to focus on the identification of cases of vaginismus in the ART scenario and on the introduction of intra-cycle interventions as part of a comprehensive, integrated and patient-centered perspective.MethodsThis observational prospective study looked into 425 IVF/ICSI cycles and 226 frozen embryo transfers carried out from January 1, 2015 to December 31, 2016, and found seven cases of vaginismus. Within a six-month period, a questionnaire placed on SurveyMonkey was sent twice to 228 ART centers in Latin America. The purpose was to learn how often cases of vaginismus were found in ART centers and the perceptions around the presence of this condition.ResultsThe few centers that took the time to answer the questionnaire (24/10.5%) stated that the number of cases in which they had trouble performing control ultrasound examination or needed to perform transfers with patients under sedation was not significant. Although 81% agreed that the incidence of these conditions is low, no references were made to cases of vaginismus, dyspareunia or sexual dysfunction. Our multidisciplinary team found seven cases of vaginismus, involving women with higher education degrees with a mean age of 37.8 years and married for a mean of four years. Although two reported they were able to tolerate intercourse, all reported undergoing treatments such as using vaginal dilators (3), psychotherapy (4) and psychiatric care (1). The care provided by the staff was designed to mitigate patient suffering.ConclusionGentle care and sensitive listening should be integral components in the work of multidisciplinary teams to identify women with vaginismus and offer couples better quality treatment.

Psychological Indicators of Sexual Quality of Life in Vaginismus-afflicted Women: A Cross-Sectional Study.

“…Anxiety is a state of worry and discomfort that could make a person feel insecure, inadequate, and worn out to the point where they lose control of themselves. In the body, anxiety has several negative repercussions (13) . Among the most significant mood disorders, depression is characterized by depressive state, lack of enthusiasm, guilty and worthlessness, disturbed sleeping and eating habits, decreased energy, and difficulty concentrating, as described by the World Health Organization (WHO) (14) .…”

A trajetória do vaginismo e seu impacto na vida sexual de mulheres no menacme

“…Em decorrência do medo, outros sintomas como náusea, sudorese, dispneia, taquicardia e contrações dos músculos adutores de coxa e de todo o corpo podem fazer parte do relato de quem possui vaginismo (Tomen et al, 2015). Souza et al (2018) e Silva et al (2019) ressaltam ainda que, na maioria das vezes, esses sintomas antecipam a penetração, surgindo com a intenção ou a tentativa apenas da introdução.…”

Importance of gynecological assessment for the treatment of vaginismus as a predictive value

“…It is estimated that its prevalence is approximately 0.5–1% in the community; however, it increases up to 42% among women who attend to clinics specialized for sexual dysfunctions 2,3 . If the women with vaginismus are not properly cared for, they may also be sufferers in reproductive centers, apart from the psychological and relationship problems 4 . There are not evidence‐based standardized protocols for the treatment of vaginismus due to a lack of research and the variability of definitions over time 3 .…”