The effect of hypnotherapy on vulvovaginal pain. A systematic literature review

• Vulvodynia and vaginismus is prevalent chronic pain conditions with multifactorial aetiology. • Hypnotherapy has shown effectiveness in treating chronic pain conditions such as vulvodynia and vaginismus. • A mixed methods design should be used when exploring diagnosis like chronic vulvovaginal pain conditions. • RCTs may be insufficient to capture the nuanced experiences of patients with chronic vulvovaginal pain conditions. Vulvovaginal pain comprises diagnoses as vulvodynia and vaginismus; chronic pain conditions affecting 10–15% of women globally. The condition presents significant diagnostic and therapeutic challenges due to its multifactorial aetiology, which includes sexual, biological, psychological, and social factors. This study aimed to evaluate the existing literature on hypnotherapy as a treatment for vulvovaginal pain through systematic searches and quality assessments. Methods: A systematic literature search was conducted January 3rd, 2023, using the Ovid platform to search EMBASE, MEDLINE, and APA PsycInfo databases. The included trials were assessed using the GRADE system. Results. The review identified four studies involving seventy-three participants (64 with vaginismus and nine with vulvar vestibulitis syndrome), originating from Türkiye, Saudi Arabia, and Canada, all suggested positive effects of hypnotherapy on vulvovaginal pain. The participants were predominantly premenopausal, married, and relatively highly educated, limiting generalizability. Study designs included one pragmatic randomized trial, two prospective cohorts, and one case report; all were assessed as ‘very low’ quality on the GRADE scale, with limitations relating to sample size, lack of control groups, and non-validated outcome measures. Despite these methodological issues, all studies suggested potential beneficial effects of hypnotherapy on pain reduction, sexual function, and anxiety. Conclusion. While hypnotherapy shows potential as a treatment for vulvodynia and vaginismus, the current evidence is insufficient to confirm its efficacy. Further research employing innovative study designs that combine qualitative and quantitative data is crucial to advancing understanding and improving care for women affected by these chronic pain conditions.