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

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 tria...

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Main Authors: Macey, Kat, Gregory, Angela, Nunns, David, das Nair, Roshan
Format: Article
Published: BioMed Central 2015
Subjects:
Online Access:https://eprints.nottingham.ac.uk/33836/
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author Macey, Kat
Gregory, Angela
Nunns, David
das Nair, Roshan
author_facet Macey, Kat
Gregory, Angela
Nunns, David
das Nair, Roshan
author_sort Macey, Kat
building Nottingham Research Data Repository
collection Online Access
description 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.
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spelling nottingham-338362020-05-04T17:10:28Z https://eprints.nottingham.ac.uk/33836/ 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 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. BioMed Central 2015-06-20 Article PeerReviewed Macey, Kat, Gregory, Angela, Nunns, David and das Nair, Roshan (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 . 49/1-49/12. ISSN 1472-6874 Vaginismus Vaginal trainers Dilators http://dx.doi.org/10.1186/s12905-015-0201-6 doi:10.1186/s12905-015-0201-6 doi:10.1186/s12905-015-0201-6
spellingShingle Vaginismus
Vaginal trainers
Dilators
Macey, Kat
Gregory, Angela
Nunns, David
das Nair, Roshan
Women’s experiences of using vaginal trainers (dilators) to treat vaginal penetration difficulties diagnosed as vaginismus: a qualitative interview study
title Women’s experiences of using vaginal trainers (dilators) to treat vaginal penetration difficulties diagnosed as vaginismus: a qualitative interview study
title_full Women’s experiences of using vaginal trainers (dilators) to treat vaginal penetration difficulties diagnosed as vaginismus: a qualitative interview study
title_fullStr Women’s experiences of using vaginal trainers (dilators) to treat vaginal penetration difficulties diagnosed as vaginismus: a qualitative interview study
title_full_unstemmed Women’s experiences of using vaginal trainers (dilators) to treat vaginal penetration difficulties diagnosed as vaginismus: a qualitative interview study
title_short Women’s experiences of using vaginal trainers (dilators) to treat vaginal penetration difficulties diagnosed as vaginismus: a qualitative interview study
title_sort women’s experiences of using vaginal trainers (dilators) to treat vaginal penetration difficulties diagnosed as vaginismus: a qualitative interview study
topic Vaginismus
Vaginal trainers
Dilators
url https://eprints.nottingham.ac.uk/33836/
https://eprints.nottingham.ac.uk/33836/
https://eprints.nottingham.ac.uk/33836/