Skip to main content
Log in

“Throwing the Baby Out with the Bathwater”: The Demise of Vaginismus in Favor of Genito-Pelvic Pain/Penetration Disorder

  • Commentary on DSM-5
  • Published:
Archives of Sexual Behavior Aims and scope Submit manuscript

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  • American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.) Washington, DC: Author.

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.) Arlington, VA: Author.

  • Badran, W., Moamen, N., Fahmy, I., El-Karaksy, A., Adbel-Nasser, T. M., & Ghanem, H. (2006). Etiological factors of unconsummated marriage. International Journal of Impotence, 18, 458–463.

    Article  Google Scholar 

  • Binik, Y. M. (2005a). Should dyspareunia be retained as a sexual dysfunction in DSM-V? A painful classification decision. Archives of Sexual Behavior, 34, 11–21.

    Article  PubMed  Google Scholar 

  • Binik, Y. M. (2005b). Dyspareunia looks sexy on first but how much pain will it take for it to score? A reply to my critics concerning the DSM classification of dyspareunia as a sexual dysfunction. Archives of Sexual Behavior, 34, 63–67.

    Article  PubMed  Google Scholar 

  • Binik, Y. M. (2010a). The DSM diagnostic criteria for dyspareunia. Archives of Sexual Behavior, 39, 292–303.

    Article  PubMed  Google Scholar 

  • Binik, Y. M. (2010b). The DSM diagnostic criteria for vaginismus. Archives of Sexual Behavior, 39, 278–291.

    Article  PubMed  Google Scholar 

  • Binik, Y. M., Bergeron, S., & Khalifé, S. (2007). Dyspareunia and vaginismus: So-called sexual pain. In S. R. Leiblum (Ed.), Principles and practice of sex therapy (4th ed., pp. 124–156). New York: Guilford Press.

    Google Scholar 

  • Blok, B. F., Sturms, L. M., & Holstege, G. A. (1997). PET study on cortical and subcortical control of pelvic floor musculature in women. Journal of Comparative Neurology, 389, 535–544.

    Article  PubMed  Google Scholar 

  • Borg, C., de Jong, P. J., & Weijmar Schultz W. C. M. (2010). Vaginismus and dyspareunia: Automatic vs. deliberate disgust responsivity. Journal of Sexual Medicine, 7, 2149–2157.

  • Borg, C., de Jong, P. J., & Weijmar Schultz, W. C. M. (2011). Vaginismus and dyspareunia: Relationship with general and sex-related moral standards. Journal of Sexual Medicine, 8, 223–231.

    Article  PubMed  Google Scholar 

  • Borg, C., Georgiadis, R. J., Renken, R. J., Spoelstra, K., Weijmar Schultz, W. C. M., & de Jong, P. J. (2014). Brain processing of sexual penetration versus core and animal-reminder disgust pictures in women with lifelong vaginismus. PLoS ONE, 9, e84882.

    Article  PubMed Central  PubMed  Google Scholar 

  • Borg, C., Peters, L. M., Weijmar Schultz, W. C. M., & de Jong, P. J. (2012). Vaginismus: Heightened harm avoidance and pain catastrophic cognitions. Journal of Sexual Medicine, 9, 558–567.

    Article  PubMed  Google Scholar 

  • Both, S., van Lunsen, R., Weijenborg, P., & Laan, E. (2012). A new device for simultaneous measurement of pelvic floor muscle activity and vaginal blood flow: A test in a nonclinical sample. Journal of Sexual Medicine, 9, 2888–2892.

    Article  PubMed  Google Scholar 

  • Broens, P. M. A., Spoelstra, S. K., & Weijmar Schultz, W. C. M. (2014). Dynamic clinical measurements of voluntary vaginal contractions and autonomic vaginal reflexes (under review).

  • Cherner, R. A., & Reissing, E. D. (2013a). A psychophysiological investigation of sexual response in women with lifelong vaginismus. Journal of Sexual Medicine, 10, 1291–1303.

    Article  PubMed  Google Scholar 

  • Cherner, R. A., & Reissing, E. D. (2013b). A comparative study of sexual function, behavior, and cognitions of women with lifelong vaginismus. Archives of Sexual Behavior, 42, 1605–1614.

    Article  PubMed  Google Scholar 

  • de Jong, P. J., van Overveld, M., & Borg, C. (2013). Giving into arousal or staying stuck in disgust: Disgust-based mechanism in sex and sexual dysfunction. Annual Review of Sex Research, 50, 247–262.

    Google Scholar 

  • de Jong, P. J., van Overveld, M., Weijmar Schultz, W. C. M., Peters, M. L., & Buwalda, F. M. (2009). Disgust and contamination sensitivity in vaginismus and dyspareunia. Archives of Sexual Behavior, 38, 244–252.

    Article  PubMed  Google Scholar 

  • de Kruiff, M. E., ter Kuile, M. M., Weijenborg, P. Th. M., & van Lankveld, J. J. D. M. (2000). Vaginismus and dyspareunia: Is there a difference in clinical presentation? Journal of Psychosomatic Obstetrics and Gynecology, 21, 149–155.

  • Dogan, S. (2009). Vaginismus and accompanying sexual dysfunctions in a Turkish clinical sample. Journal of Sexual Medicine, 6, 184–192.

    Article  PubMed  Google Scholar 

  • Engman, M., Lindehammar, H., & Wijma, B. (2004). Surface electromyography diagnostics in women with partial vaginismus with or without vulvar vestibulitis and asymptomatic women. Journal of Psychosomatic Obstetrics and Gynecology, 25, 281–294.

    Article  PubMed  Google Scholar 

  • Har-Toov, J., Militscher, I., Lessing, J. B., Abramov, L., & Chen, J. (2001). Combined vulvar vestibulitis syndrome with vaginismus: Which to treat first? Journal of Sex & Marital Therapy, 27, 527–523.

  • Klaassen, M., & ter Kuile, M. M. (2009). The development and initial validation of the Vaginal Penetration Cognition Questionnaire (VPCQ) in a sample of women with vaginismus and dyspareunia. Journal of Sexual Medicine, 6, 1617–1627.

    Article  PubMed  Google Scholar 

  • Landry, T., Bergeron, S., Dupuis, M. J., & Desrochers, G. (2008). The treatment of provoked vestibulodynia: A critical review. Clinical Journal of Pain, 24, 155–171.

    Article  PubMed  Google Scholar 

  • Masheb, R. M., Kerns, R. D., Lozano, C., Minkin, M. J., & Richman, S. (2009). A randomized clinical trial for women with vulvodynia: Cognitive-behavioral therapy vs. supportive psychotherapy. Pain, 141, 21–40.

    Article  Google Scholar 

  • Meana, M., & Binik, Y. M. (1994). Painful coitus: A review of female dyspareunia. Journal of Nervous and Mental Disease, 182, 264–272.

    Article  PubMed  Google Scholar 

  • Melles, R. J., Ter Kuile, M. M., Dewitte, M., Van Lankveld, J. J. D. M., Brauer, M., & De Jong, P. J. (2014). Automatic and deliberate affective associations with sexual stimuli in women with vaginismus before and after therapist-aided exposure treatment. Journal of Sexual Medicine, 11, 786–799.

    Article  PubMed  Google Scholar 

  • Melnik, T., Hawton, K., & McGuire, H. (2012). Interventions for vaginismus. The Cochrane database of systematic reviews, 12. doi:10.1002/14651858.CD001760.pub2.

  • Michetti, P. M., Silvaggi, M., Fabrizi, A., Tartaglia, N., Rossi, R., & Simonelli, C. (2013). Unconsummated marriage: Can it still be considered a consequence of vaginismus? International Journal of Impotence Research, 26, 28–30.

    Article  PubMed  Google Scholar 

  • Nabil Mhiri, M., Smaoui, W., Bouassida, M., Chabchoub, K., Masmoudi, J., et al. (2013). Unconsummated marriage in the Arab Islamic world: Tunisian experience. Sexologies: European Journal of Sexology and Sexual Health, 22, e71–e76.

  • Reissing, E. D. (2009). Vaginismus. In A. T. Goldstein, C. F. Pukall, & I. Goldstein (Eds.), Female sexual pain disorders: Evaluation and management (pp. 229–234). Oxford: Blackwell Publishing.

    Chapter  Google Scholar 

  • Reissing, E. D. (2012). Consultation and treatment history and causal attributions in an online sample of women with lifelong and acquired vaginismus. Journal of Sexual Medicine, 9, 251–258.

    Article  PubMed  Google Scholar 

  • Reissing, E. D., Binik, Y. M., & Khalifé, S. (1999). Does vaginismus exist? A critical review of the literature. Journal of Nervous and Mental Disease, 187, 261–274.

    Article  PubMed  Google Scholar 

  • Reissing, E. D., Binik, Y. M., Khalifé, S., Cohen, D., & Amsel, R. (2004). Vaginal spasm, pain, and behavior: An empirical investigation of the diagnosis of vaginismus. Archives of Sexual Behavior, 33, 5–17.

    Article  PubMed  Google Scholar 

  • Rozin, P., Nemerhoff, C., Horowitz, M., Gordon, B., & Voet, W. (1995). The borders of the self: Contamination sensitivity and potency of the body apertures and other body parts. Journal of Research in Personality, 29, 318–340.

    Article  Google Scholar 

  • Shafik, A., & El Sibai, F. (2002). Study of the pelvic floor muscles in vaginismus: A concept of pathogenesis. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 105, 67–70.

    Article  PubMed  Google Scholar 

  • Sims, M. J. (1861). On vaginismus. Transactions of the Obstetrics Society of London, 3, 356–367.

    Google Scholar 

  • Spoelstra, S. K., Dijkstra, J. R., van Driel, M. F., & Weijmar Schultz, W. M. W. (2011). Long-term results of an individualized, multifaceted, and multidisciplinary therapeutic approach to provoked vestibulodynia. Journal of Sexual Medicine, 8, 489–496.

    Article  PubMed  Google Scholar 

  • Spoelstra, S. K., Reissing, E. D., Borg, C., & Weijmar Schultz, W. C. M. (2014). Psycho-genito-pelvic reflex theory in genito-pelvic pain/penetration disorder. Manuscript submitted for publication.

  • ter Kuile, M. M., Both, S., & Van Lankveld, J. J. D. M. (2010). Cognitive behavioral therapy for sexual dysfunctions in women. Psychiatric Clinic of North America, 33, 595–610.

    Article  Google Scholar 

  • ter Kuile, M. M., Bulte, I., Weijenborg, P. T. M., Beekman, A., Melles, R., & Onghena, P. (2009). Therapist-aided exposure for women with lifelong vaginismus: A replicated single-case design. Journal of Consulting and Clinical Psychology, 77, 149–159.

    Article  PubMed  Google Scholar 

  • ter Kuile, M. M., Melles R. J., de Groot, H. E., Tuijnman-Raasveld, & van Lankveld, J. J. D. M. (2013). Therapist-aided exposure for women with lifelong vaginismus: A randomized waiting-list control trial of efficacy. Journal of Consulting and Clinical Psychology, 81, 1127–1136.

  • ter Kuile, M. M., & Reissing, E. D. (2014). Lifelong vaginismus. In Y. M. Binik & K. Hall (Eds.), Principles and practice of sex therapy (5th ed., pp. 177–192). New York: Guilford Press.

  • ter Kuile, M. M., van Lankveld, J. J. D. M., Vliet Vlieland, C. V., Willekes, C., & Weijenborg, P. T. M. (2005). Vulvar vestibulitis syndrome: An important factor in the evaluation of lifelong vaginismus? Journal of Psychosomatic Obstetrics and Gynecology, 26, 245–249.

    Article  PubMed  Google Scholar 

  • Trotula of Salerno. (1940). The diseases of women (W. Mason-Hohl, Trans.). Los Angeles: The Ward Ritchie Press.

  • van der Velde, J., & Everaerd, W. (2001). The relationship between involuntary pelvic floor muscle activity, muscle awareness and experienced threat in women with and without vaginismus. Behaviour Research and Therapy, 39, 395–408.

    Article  PubMed  Google Scholar 

  • van der Velde, J., Laan, E., & Everaerd, W. (2001). Vaginismus, a component of a general defensive reaction: An investigation of pelvic floor muscle activity during exposure to emotion-inducing film excerpts in women with and without vaginismus. International Urogynecology Journal of Pelvic Floor Dysfunction, 12, 328–331.

    Article  Google Scholar 

  • van Overveld, M., de Jong, P. J., Peters, M. L., van Lankveld, J. J. D. M., Melles, R., & ter Kuile, M. M. (2013). The Sexual Disgust Questionnaire: A psychometric study and a first exploration in patients with sexual dysfunctions. Journal of Sexual Medicine, 10, 396–407.

    Article  PubMed  Google Scholar 

  • Weijmar Schultz, W. C. M., Basson, R., Binik, Y., Eschenbach, D., Wesselmann, U., & van Lankveld, J. J. D. M. (2005). Women’s sexual pain and its management. Journal of Sexual Medicine, 2, 301–316.

    Article  PubMed  Google Scholar 

  • Yartz, A. R., & Hawk, L. W. (2002). Addressing the specificity of affective startle modulation: Fear versus disgust. Biological Psychology, 59, 55–68.

    Article  PubMed  Google Scholar 

  • Yasan, A., & Akdeniz, N. (2009). Treatment of lifelong vaginismus in traditional Islamic couples: A prospective study. Journal of Sexual Medicine, 6, 1054–1061.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Elke D. Reissing.

Additional information

Charmaine Borg and Symon K. Spoelstra are both second authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Reissing, E.D., Borg, C., Spoelstra, S.K. et al. “Throwing the Baby Out with the Bathwater”: The Demise of Vaginismus in Favor of Genito-Pelvic Pain/Penetration Disorder. Arch Sex Behav 43, 1209–1213 (2014). https://doi.org/10.1007/s10508-014-0322-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10508-014-0322-2

Keywords

Navigation