Original Articles

Insights Into the Vaginismus Treatment by Cognitive Behavioral Therapies: Correlation With Sexual Dysfunction Identified in Male Spouses of the Patients


Objective: To examine retrospectively sexual dysfunction in the male spouses of 425 female patients who had presented to our clinic and were diagnosed with primary vaginismus.
Materials and methods: Seven questions related to age, profession, educational status, number of marriages, personality structure, sexual experience, and sexual dysfunction history were directed to the spouses of the 425 female patients presenting to our clinic for vaginismus treatment between 2015 and 2018. Men reporting sexual dysfunction were evaluated by a urologist, and the necessary treatment was initiated. Cognitive-behavioral couple therapy was started for all patients.
: Of the 425 men, 73.9% stated that they did not have any sexual problems. Of the 111 men (26.1%) stated that they had one or more sexual problems, 77 (18.1%) were diagnosed with premature ejaculation, 25 (5.8%) erectile dysfunction, 36 (8.4%) hypoactive sexual desire, and one (0.2%) had delayed ejaculation. Premature ejaculation and erectile dysfunction were identified in nine patients, premature ejaculation and hypoactive sexual desire in seven, and erectile dysfunction and hypoactive sexual desire in four patients. There was an increased rate of sexual dysfunction in men in cases where the duration of marriage without coitus was longer than three years.
Conclusion: In the treatment of vaginismus, male sexual dysfunction should not be ignored. Spouses should be questioned for sexual dysfunction and included in the treatment process.

1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). 5th edition Virginia: American Psychiatric Publishing, 2013.
2. Butcher J. ABC of Sexual Health: Female Sexual Problems II: Sexual Pain and Sexual Fears. BMJ 1999; 318: 110-2.
3. Kaplan HS. The New Sex Therapy: Active Treatment of Sexual Dysfunctions. New York: 1th edition, Routledge, 1974.
4. 4. Masters WH, Johnson VE. Human Sexual Inadequacy. Little Brown: Boston, 1970.
5. Anğın AD, Gün İ, Sakin Ö, Çıkman MS, Eserdağ S, Anğın P. Effects of predisposing factors on the success and treatment period in vaginismus. JBRA Assist Reprod 2020; 24: 180-8.
6. Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, Mc Kinlay JB. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. JUrol 1994; 151: 54- 61.
7. Hehemann MC, Kashanian JA. Can lifestyle modification affect men’s erectile function? Transl Androl Urol. 2016; 5:187-94.
8. Gillman N, Gillman M. Premature Ejaculation: Aetiology and Treatment Strategies. Med Sci (Basel) 2019; 7: 102.
9. Master VA, Turek PJ. Ejaculatory physiology and dysfunction. Urol Clin North Am 2001; 28: 363-75.
10. Montague DK, Jarow J, Broderick GA, Dmochowski RR, Heaton JP, Lue TF, et al. AUA guideline on the pharmacologic management of premature ejaculation.
J Urol 2004; 172: 290–4.
11. Park HJ, Park JK, Park K, Lee SW, Kim SW, Yang DY, et al. Prevalence of premature ejaculation in young and middle-aged men in Korea: a multicenter internet-based survey from the Korean Andrological Society. Asian J Androl 2010; 12: 880-9.
12. Serefoglu EC, Yaman O, Cayan S, Asci R, Orhan I, Usta MF, et al. The comparison of premature ejaculation assessment questionnaires and their sensitivity for the four premature ejaculation syndromes: results from the Turkish Society of Andrology Sexual Health Survey.
J Sex Med 2011; 8: 1177–85.
13. Gao J, Zhang X, Su P, Liu J, Xia L, Yang J, et al. Prevalence and factors associated with the complaint of premature ejaculation and the four premature ejaculation syndromes: A large observational study in China. J Sex Med 2013; 10: 1874–81.
14. Lamont JA. Vaginismus: a reflex response out of control. Contemporary Obstetrics and Gynecology 1994; 3: 30-2.
15. Ohl LE. Essentials of female sexual dysfunction from a sex therapy perspective. Urol Nurs 2007; 27: 57-63.
16. Shokrollahi P, Mirmohamadi M, Mehrabi F, Babaei G. Prevalence of sexual dysfunction in women seeking services at family planning centers in Tehran. J Sex Marital Ther 1999; 25: 211-5.
17. Bachmann G. Female sexuality and sexual dysfunction: Are we stuck on the learning curve? J Sex Med 2006; 3: 639-45.
18. Ozdemir O, Simsek F, Ozkardes S, Incesu C, Karakoç B. The unconsummated marriage: its frequency and clinical characteristics in a sexual dysfunction clinic.
J Sex Marital Ther 2008; 34: 268-79.
19. Michetti PM, Silvaggi M, Fabrizi A, Tartaglia, Rossi R, Simonelli C. Unconsummated marriage: can it still be considered a consequence of vaginismus? Int J Impot Res 2014; 26: 28-30.
20. Cayan S, Bozlu M, Canpolat B, Akbay E. The assessment of sexual functions in women with male partners complaining of erectile dysfunction: Does treatment of male sexual dysfunction improve female partner’s sexual functions? J Sex Marital Ther 2004; 30: 333–41.
21. Greenstein A, Abramov L, Matzkin H, Chen J. Sexual dysfunction in women partners of men with erectile dysfunction. Int J Impot Res 2006; 18: 44–46.
22. Renshaw D. Coping with an impotent husband. Illinois Medical Journal 1981; 159, 29–33
23. Fisher WA, Rosen RC, Eardley I, Sand M, Goldstein I. Sexual experience of female partners of men with erectile dysfunction: The female experience of men’s attitudes to life events and sexuality (FEMALES) study. J Sex Med 2005; 2: 675–84.
24. Conaglen HM, Conaglen JV. The impact of erectile dysfunction on female partners: a qualitative investigation. Sexual and Relationship Therapy 2008; 23: 147–56.
25. Efe E. Erkek Cinsel İşlev Bozukluklarının Partnerinin Cinsel Yaşamı Üzerine Etkileri. The Effects of Male Sexual Dysfunctions on Partner's Sexual. LifeTürkiye Klinikleri 2015; 8:62-6.
26. Şimşek A, Kandemir E. Prematür ejakülasyona güncel bakış ve tedavisindeki yenilikler. Current view of premature ejaculation and innovations in its treatment (Review). Androloji Bülteni 2014; 16: 1-7.
27. Burri A, Giuliano F, McMahon C, Porst H. Female partner’s perception of premature ejaculation and its impact on relationship breakups, relationship quality, and sexual satisfaction. J Sex Med 2014; 11: 2243–55.
28. Hobbs K, Symonds T, Abraham L, May K, Morris MF. Sexual dysfunction in partners of men with premature ejaculation Int J Impot Res 2008; 20: 512-7.
29. Hartmann U, Schedlowski M, Krüger TH. Cognitive and partner-related factors in rapid ejaculation: Differences between dysfunctional and functional men. World J Urol 2005; 23: 93–101.
30. Riley A, Riley E. Premature ejaculation: presentation and associations. An audit of patients. Int J Clin Pract 2005; 59: 1482–7.
31. Dogan S, Dogan M. The frequency of sexual dysfunctions in male partners of women with vaginismus in a Turkish sample. Int J Impot Res 2008; 20: 218-21.
32. Sungur M. Evaluation of couples referred to a sexual dysfunction unit and prognostic factors in sexual and marital therapy. J Sex Marital Ther 1994; 9:251-65.
33. Oktay M, Tombul K. Two hundred cases of vaginismus: The patients, and their husband's psychological evaluation. New Symposium 2003; 41:115–9.
34. Reissing ED, Binik, YM, Khalifé, S. Does vaginismus exist? A critical review of the literature. J Nerv Ment Dis 1999; 187: 261-74.
35. Davis HJ, Reissing ED. Relationship adjustment and dyadic interaction in couples with sexual pain disorders: A critical review of the literature.Sexual and Relationship Therapy 2007; 22: 245-54.
36. Turan Ş, Usta Sağlam NG, Bakay H, Gökler ME. Levels of Depression and Anxiety, Sexual Functions, and Affective Temperaments in Women with Lifelong Vaginismus and Their Male Partners. J Sex Med 2020; 17: 2434-45.
37. Lahaie MA, Boyer SC, Amsel R, Khalifé S, Binik YM. Vaginismus: a review of the literature on the classification/diagnosis, etiology and treatment. Womens Health (Lond) 2010; 6: 705-19.
38. Munasinghe T, Goonaratna C, de Silva P. Couple characteristics and outcome of therapy in vaginismus. Ceylon Med J 2004; 49: 54–7.
39. Eserdağ S, Anğın AD. Importance of gynecological assessment for the treatment of vaginismus as a predictive value. J Obstet Gynaecol Res 2020.
IssueVol 15, No 1 (March 2021) QRcode
SectionOriginal Articles
DOI https://doi.org/10.18502/jfrh.v15i1.6079
Vaginismus Sexual Dysfunctions Erectile Dysfunction

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Eserdag S, Kurban D, Yakut E, Mishra P. Insights Into the Vaginismus Treatment by Cognitive Behavioral Therapies: Correlation With Sexual Dysfunction Identified in Male Spouses of the Patients. J Fam Reprod Health. :61-69.