Effectiveness of Biofeedback with Dilator Therapy for Sexual Function in Women with Primary Vaginismus: Randomized Controlled Trial Study

Abstract

Introduction and Hypothesis Vaginismus is characterized by the involuntary spasm of the pelvic floor muscles (PFMs) around the outer third of the vagina, leading to difficulties in vaginal penetration. Physical therapists often use biofeedback to help individuals to gain better control over their muscles. This study was aimed at assessing the impact of biofeedback with dilator therapy on sexual function in women with primary vaginismus. Methods In this randomized controlled trial study, 32 women with primary vaginismus, aged 18 to 45, were randomly assigned to either the experimental group (n = 16) or the control group (n = 16). The experimental group received both dilator therapy and biofeedback training, whereas the control group only received dilator therapy. Both groups followed a 6-week, twice-a-week session program. The Female Sexual Function Index (FSFI) questionnaire, which includes six dimensions (desire, arousal, lubrication, orgasm, satisfaction, and pain), was administered before and after the 6-week treatment, as well as 1 month after completion. Results The analysis of variance test showed that the interaction effect of the group and time on the overall score of sexual function (p < 0.001) and the aspects of desire (p < 0.001), arousal (p < 0.001), orgasm (p = 0.028), satisfaction (p < 0.001), and pain (p = 0.003) were significant; however, the interaction between group and time (p = 0.182) was not observed for lubrication. Conclusion Biofeedback therapy combined with dilator therapy and dilator therapy alone are both effective in improving sexual function in women with primary vaginismus. However, women undergoing biofeedback combined with dilator therapy seem to benefit more than those receiving dilators alone.