ABSTRACT
INTRODUCTION: Vulvar vestibulitis syndrome (VVS) is a diverse, multifactorial phenomenon. Its precise etiology is unknown. AIM: To define the association between oral contraceptive (OC) estrogen dosage and VVS. Methods. Women diagnosed as having VVS participated in the study. MAIN OUTCOME MEASURES: Data on type and usage of oral contraceptive pills (OC) were obtained by a questionnaire, and they were compared for the data on OC usage in the general population. RESULTS: Available commercial data on Israeli women taking OC showed that 51% of them use low-dose estrogen (
Subject(s)
Contraceptives, Oral, Hormonal/adverse effects , Estrogens/adverse effects , Vulvar Vestibulitis/diagnosis , Vulvar Vestibulitis/epidemiology , Women's Health , Adult , Contraception Behavior/statistics & numerical data , Contraceptives, Oral, Hormonal/administration & dosage , Dose-Response Relationship, Drug , Estrogens/administration & dosage , Female , Humans , Israel/epidemiology , Vulvar Vestibulitis/chemically inducedABSTRACT
OBJECTIVE: To prospectively assess and compare a novel approach to the treatment of vaginismus based on Paula Garburg's sphincter muscle exercises to the traditional approach based on Masters & Johnson. PATIENTS AND METHODS: The study population included 60 consecutive patients with vaginismus who were referred to our sex therapy clinic. The patients were randomly assigned into two groups. The study group (30 patients) underwent a step-by-step program consisting of the performance of the Paula Garburg sphincter muscle exercises to achieve pelvic muscle relaxation combined with the active introduction of Young vaginal dilators of graduated size. A control group (30 patients) underwent a behavioral treatment based on Masters and Johnson's desensitization approach that was combined with the active introduction of Young vaginal dilators of graduated size. RESULTS: All patients completed the program, all with a successful outcome, as defined by the achievement of full intercourse or the introduction of a number 6 Young vaginal dilator. The mean number of treatment sessions required for successful outcome was shorter in the study as compared to the control group (4.9 +/- 1.4 vs. 7.4 +/- 3.5, respectively. P < 0.001). Furthermore, while the percentage of patients undergoing up to 5 sessions until successful outcome was significantly higher in the study as compared to the control group (p < 0.05), the percentage of patients undergoing > 10 sessions was significantly lower. CONCLUSION: Paula Garburg's sphincter muscle exercises together with the use of Young vaginal dilators is a simple, easy and very effective treatment for vaginismus. The outcome matched or even surpassed that of the traditional behavioral approaches.
