The effect of mindfulness-based theraphy on sexual satisfaction and pain threshold levels in patients diagnosed with vaginismus

Objective: In this study, it has been intended to observe that whether there is a difference in the level of pain threshold between patients with vaginismus and the control group and to determine possible changes in pain threshold levels, pain-related cognitions, sexual satisfaction, anxiety and depression levels, and mindfulness levels among the patients with vaginismus that the MBSR therapy program applied. Materials-Methods: The patient group in our study includes 40 women who admitted to the Ankara City Hospital Psychiatry and Gynecology and Obstetrics outpatient clinic between March 2021 and July 2021, and were diagnosed with 'Pain in the Sexual Organs-Pelvis/Peel Penetration Disorder' as a result of the evaluation made according to the DSM-5 diagnostic criteria and who agreed to participate in the study and signed the informed consent form. The healthy control group of the study consisted of 32 sexually active female volunteers who were not diagnosed with DSM-5 CIB according to the clinical interview and were statistically correlated with the patients in terms of age and education status. Participants were divided into three groups as healthy control, intervention and waiting groups. MBSR therapy program was applied to the intervention group. Before the start of the program and after the program was completed, pain threshold measurements were made with an algometer and GRCDO, SCL-90-R, BBBFO, BAO, BDO, VPBO, AFO were applied to the participants. The same applications were applied to the waiting group twice in 8 weeks apart, and once to the control group. Findings: There was no significant difference between vaginismus and healthy control groups in terms of marital status, education level, place of residence, talking about sexuality in the family. The pain threshold level was found to be significantly lower in the vaginismus group in all regions measured with the algometer. In the vaginismus group, compared to the control group, the total score of AFO and subscales of rumination, exaggeration, pessimism, BDO and BAO scores, GRDO total score, frequency, satisfaction, avoidance, vaginismus, anorgasmia subscales, SCL-90-R total score and all subscale scores, VPBO total score and subscales of control cognitions, self-image cognitions, catastrophizing and pain cognitions, sexual (genital) incompatibility cognitions were found to be significantly higher. In the vaginismus group, compared to the control group, the BBFO total score, non-judgmental and unresponsiveness to internal experiences subscales were found to be significantly lower. When the results before and after the MBSR therapy program applied to the intervention group were compared; A significant increase was found in the pain threshold level, BBBFO total score and observation subscale in all regions where the right spina iliaca anterior superior muscle was measured, except for the region where the right spina iliaca anterior superior muscle is located. A significant decrease was found in the AFO exaggeration subscale score, BDO, SCL-90-R total score, somatization, OKB, interpersonal sensitivity, depression, anxiety, anger, psychotism subscales, VPBO total score and control cognitions, catastrophizing and pain cognitions, the sexual genital dissonance cognitions subscales, the GRCDO vaginismus and anorgasmia subscales. Conclusion: As a result of our study, it was observed that there was a significant difference in the pain threshold level between the vaginismus and control groups, confirming our hypothesis, and that there was an improvement in the pain threshold level, vaginal penetration cognition and various parts of sexual satisfaction after the MBSR therapy program. In addition, it was observed that sexual intercourse occurred and vaginismus complaints regressed in 8 of the patients who underwent MBSR therapy program in the clinical course. Vaginal examination was possible in 2 of the patients. Keywords: Vaginismus, Pain threshold, Conscious awareness, Mindfulness, Algometer.