(O-26) Therapeutic approaches to vaginismus: a systematic review of randomized controlled trials

Abstract Objective Vaginismus, despite a 1%-7% prevalence, remains largely underexplored in scientific literature. This study aims to analyze therapeutic approaches to vaginismus through reviewing consolidated and relevant scientific articles. Methods A systematic search for studies published between 2015 and 2025 in PubMed was conducted, using search terms (i) “vaginismus,” “sexual dysfunction” and (ii) “treatment.” Only randomized studies were included and after screening titles and abstracts for eligibility, 6 were selected. Results Various interventions improved the Female Sexual Function Index (FSFI). Aslan et al. based on the Information-Motivation-Behavioral Skills model, found that pelvic relaxation techniques with sexual counseling resulted in major improvements in desire, arousal, orgasm and pain, but not in lubrication, two months post-treatment. Kuile et al. observed that therapist-assisted exposure therapy led to a reduction in pain, with FSFI scores improving from 0.25 to 3.15. Zarski et al., through internet-based self-help, observed that non-coital penetration and reduced coital fear improved all FSFI domains: desire, arousal, lubrication, orgasm, satisfaction, and pain. Jokar et al., combining biofeedback with vaginal dilators, identified improvements in desire, arousal, orgasm and pain, though lubrication remained unchanged. Yaraghi et al. compared pelvic floor physiotherapy with local botulinum toxin injection, finding physiotherapy - combined with functional electrical stimulation and desensitization techniques - more effective in improving FSFI. Tajik et al. showed sensate focus plus sexual position changes in women with endometriosis improved total sexual function and reduced dyspareunia after eight weeks. Conclusions Multidisciplinary treatment is a promising approach on vaginismus; nevertheless, further studies are needed due to the significant impact of this condition on the female population. Financing No conflict.