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Women’s experiences of using vaginal trainers (dilators) to treat vaginal penetration difficulties diagnosed as vaginismus: a qualitative interview study

Macey, Kat; Gregory, Angela; Nunns, David; das Nair, Roshan

Authors

Kat Macey

Angela Gregory

David Nunns

ROSHAN NAIR Roshan.dasnair@nottingham.ac.uk
Professor of Clinical Psychology and Neuropsychology



Abstract

Background

Recent research has highlighted controversies in the conceptualisation, diagnosis and treatment of vaginismus. Vaginal trainers are currently the most widely used treatment. Critiques have highlighted concerns that the evidence-base of its effectiveness is limited, with controlled trials reporting disappointing results, and its prescription promotes ‘performance-based’ sexuality which may be detrimental. Despite this, little has been done to seek women’s views about their treatment. This study set out to explore women’s experiences of vaginismus treatment with vaginal trainers, and to use their voices to propose guidelines for improving treatment.

Methods

13 women who had used vaginal trainers for vaginal penetration difficulties diagnosed as vaginismus were recruited through a specialist clinic, university campuses, and online forums. The women took part in semi-structured individual interviews (face-to-face/telephone/Skype), which were audio-recorded, transcribed verbatim and analysed using Thematic Analysis.

Results

Four superordinate themes were elicited and used to draft ‘better treatment’ guidelines. Themes were: (1) Lack of knowledge, (2) Invalidation of suffering by professionals, (3) Difficult journey, and (4) Making the journey easier. This paper describes themes (3) and (4). Difficult Journey describes the long and arduous ‘Journey into treatment’, including difficulties asking for help, undergoing physical investigations and negotiating ‘the system’ of medical referrals. It also describes the sometimes demoralising process of ‘being in treatment’, which includes emotional and practical demands of treatment. Making the journey easier highlights the importance of and limits to ‘partner support’. ‘Professional support’ comprises personal qualities of professionals/therapeutic relationship, the value of specialist skills and knowledge and the need for facilitating couple communication about vaginismus. ‘Peer support/helping each other’ describes the importance of supportive vaginimus networks and sharing tips with other women.

Conclusions


Accessing effective treatment for vaginal penetration difficulties is difficult. The practical and emotional demands of using vaginal trainers may be underestimated by professionals, resulting in inadequate provision of support and information in practice. At times vaginal trainers may be prescribed to women who are unlikely to benefit from this treatment in isolation. Core communication skills like non-judgemental listening are important for supporting women through treatment. However professionals also need greater specialist knowledge, which in turn requires more detailed research. New ways to disseminate specialist knowledge and suggestions for further research are discussed.

Journal Article Type Article
Publication Date 2015-12
Journal BMC Women's Health
Electronic ISSN 1472-6874
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 15
Issue 1
Article Number 49
APA6 Citation Macey, K., Gregory, A., Nunns, D., & das Nair, R. (2015). Women’s experiences of using vaginal trainers (dilators) to treat vaginal penetration difficulties diagnosed as vaginismus: a qualitative interview study. BMC Women's Health, 15(1), https://doi.org/10.1186/s12905-015-0201-6
DOI https://doi.org/10.1186/s12905-015-0201-6
Keywords Vaginismus, Vaginal trainers, Dilators
Publisher URL http://dx.doi.org/10.1186/s12905-015-0201-6
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0
Additional Information Received: 9 April 2014; Accepted: 18 May 2015; First Online: 20 June 2015

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0





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