Therapy for Vaginismus: In Vivo versus In Vitro Desensitization

OBJECTIVE: To verify the effectiveness of desensitization exercises with dilators in the treatment of vaginismus, while comparing 2 therapeutic variations with differing instruction procedures ("in vivo" versus "in vitro") during the desensitization exercises. METHOD: A consecutive random sample of 44 female outpatients in sexual therapy were divided into groups for either treatment on a random basis. All patients were treated until the symptoms abated on the basis of a structured therapy program. The stability of the therapeutic success was verified through follow-up interviews. RESULTS: Forty-three (97.2%) of the patients were able to have sexual intercourse after an average of 6.3 therapeutic sessions. One-third reported an increase in their sexual desire. Thirty-four of 39 patients (87.2%) would be prepared to repeat the therapy. There were no significant differences in the success and the required number of consultations for the cure between the 2 groups investigated. CONCLUSIONS: Desensitization through exercises with dilators is an effective method for treating vaginismus. The choice of instruction procedure can be left to the patient.