Background & Objectives: Sexual behavior is a response to a biological motivation, which is essential for the survival of the offspring. One of the main issues in sexual relations that can cause many complications in the marital relationship is the existence of disorders in the natural cycle of sexual function (normal sexual behavior) of couples, especially women. Vaginismus is one of the most severe sexual dysfunctions in women, which has many psychological and social effects on the individual and the family. The prevalence of vaginismus is unclear. However, clinical estimates suggest that its prevalence is lower than female orgasmic disorders. Perhaps the reason is a shame, cultural factors, lack of attention to the problem, and hiding it behind a seemingly social or physical disorder. This study aimed to investigate the effectiveness of emotional-based psychotherapy on anxiety, marital adjustment, and quality of sexual life in women with vaginismus.
Methods: The research method was quasi-experimental with a pretest-posttest design and a control group. The study population included all women with vaginismus who were referred to counseling and psychotherapy clinics in Tehran City, Iran, between July and September of 2019. The sampling method was purposive (based on the research inclusion criteria). The sample size for each group was 10. The inclusion criteria were as follows: aged between 18 and 45 years, suffering from vaginismus disorder confirmed by examining the medical record, not suffering from acute mental disorders or specific physical problems, and not receiving drug therapy or psychological treatments during the last month before treatment sessions. The exclusion criteria were as follows: absence of more than two sessions from the therapy, lack of interest or consent of the patient to continue the treatment, and realizing the disorder or acute illness during the sessions. The research data in the pretest and posttest for two groups were collected using the Sexual Quality of Life-Female (SQOL-F) questionnaire (Symonds et al., 2005), Beck Anxiety Inventory (BAI) (Beck et al., 1988), and Marital Adjustment Scale (Apt & Hulbert, 1992). The experimental group received twelve 45-min sessions of emotional-based psychotherapy, and the control group did not receive any psychological intervention during this period. To describe and analyze the data, we used the descriptive (mean and standard deviation) and inferential statistics (the t test for comparing the means of independent groups, the multivariate covariance analysis and the univariate covariance analysis tests) in the SPSS25 software. The significance level of all tests was considered 0.05.
Results: Results showed a significant difference between the mean posttest scores of the control group and the experimental group in the variables of anxiety (p<0.001) and marital adjustment (p<0.001). However, no significant difference was observed between the two groups in the quality of sexual life variable (p=0.079). Based on the effect size index, 48.5% and 25.4% of the changes in the anxiety and marital adjustment scores of the two groups were due to emotional-based psychotherapy.
Conclusion: The results of this study show that emotional-based psychotherapy has a positive effect on improving marital adjustment and anxiety in women with vaginismus. So, it is recommended that emotional-based psychotherapy be used in psychotherapy clinics to improve the psychological symptoms associated with vaginismus.