070 A Systematic Approach in the Assessment of Vaginismus: Revealing New Psychological and Organic Factors

Abstract

The aim of this exploratory study is to investigate, in a cohort of subjects consulting for female sexual dysfunction (FSD), if there is a difference regarding medical and psychosocial parameters between women with vaginismus (V) and women with other sexual complaints. A consecutive series of 255 women attending our clinic for FSD was consecutively recruited. V was diagnosed according to DSM (Diagnostic and Statistical Manual of mental disorders) IV-TR criteria. Both lifelong and acquired V cases were included. Patients underwent a structured interview and physical, gynecological, laboratory, and clitoral ultrasound examinations; they completed the Female Sexual Function Index (FSFI), the Middlesex Hospital Questionnaire (MHQ), the Female Sexual Distress Scale (FSDS) Revised and the Body Uneasiness Test (BUT). V was diagnosed in 20 patients (7.8%). V sufferers were significantly younger than the rest of the sample (p<0.05). No differences were found for traditional risk factors like a history of sexual abuse, relational parameters or gynecological diseases, nor for newly investigated parameters (i.e. neurological, hormonal and metabolic alterations). Women with V showed significantly higher histrionic symptoms and traits (as detected by MHQ-H score; p<0.05) when compared to subjects with other sexual complaints. When the scores of all MHQ subscales were simultaneously introduced in a logistic model, the association between V and MHQ-H score was confirmed (p=0.013). Women with V also showed higher FSFI Pain and FSDS total scores, even after adjusting for age (p<0.05). In an age-adjusted model, FSDS total score increased as a function of the years of duration of V (p=0.032) but not as a function of its severity. In a case-control study (ratio 1:3) we confirmed all the observations.