(315) NOVEL THERAPEUTIC APPROACH FOR VAGINISMUS: A CASE REPORT

Abstract Introduction Vaginismus is a condition characterized by involuntary muscle spasms in the pelvic floor muscles, leading to pain, difficulty, or impossibility of engaging in sexual intercourse, undergoing gynecological examinations, or inserting tampons. It manifests in various forms, with symptoms varying among individuals. Pain severity ranges from mild to severe, significantly impacting the quality of life of affected women, often leading to avoidance of sexual intercourse and relationship establishment. While different types of vaginismus may affect women of various ages, primary vaginismus constitutes a permanent condition where pain has always been present during attempts to insert a tampon or initial sexual encounters, and making gynecological examinations challenging. Current treatments typically involve a combination of techniques, often requiring partner involvement, such as Systematic Desensitization. Objective This case report aims to assess the utility and safety of a novel therapeutic tool that could benefit single patients suffering from this condition. Methods A 19-year-old nulliparous woman without a stable partner was referred by gynecology with a diagnosis of genito-pelvic pain disorder/penetration disorder according to Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) criteria. Despite maintained arousal reflex and libido, she exhibited an avoidant pattern of coital relationships due to penetration pain, severely affecting her ability to engage in sexual intercourse and establish romantic bonds. The patient underwent an 8-week treatment protocol, starting with instructions for progressive vaginal exploration, three times per week, at home, using a flexible vibrating dildo device called Molto. The device was preset to vibrate at 50 Hz for 10 seconds on and 10 seconds off to promote genital vasocongestion. Improvement was assessed using the pain domain of the Female Sexual Function Index (FSFI), the Patient Global Impression of Change (PGIC) questionnaire, and the number of coital relationships from the 4th week onwards. Results The FSFI pain domain score increased from 0 to 4.8 (range 0-6), indicating significant relief with treatment, as corroborated by the patient's response on the PGIC questionnaire ("much better"). Additionally, the patient reported five coital relationships from the 5th to the 8th week, suggesting treatment utility and improved quality of life. Conclusions While these findings require validation in case series and randomized clinical trials, this individualized vibratory device therapy offers several advantages, particularly its suitability for patients without stable partners, requiring fewer consultations compared to conventional treatments. This innovative approach represents a promising avenue for addressing vaginismus, providing a tailored solution for individuals who may not have access to, or benefit from traditional therapies. Further research is warranted to establish its utility and safety conclusively and to explore its potential for broader application in clinical practice. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Mysteryvibe.