The aim of this study was to measure the prevalence of alexithymia and emotional dysregulation in women with vaginismus not associated with other organic or psychopathological disorders. The study involved the psychometric assessment of 41 patients with vaginismus and 100 healthy women, all of childbearing age. Alexithymia was evaluated by TAS-20 (Toronto Alexithymia Scale). Sexual function was assessed by FSFI (Female Sexual Function Index). In patients with vaginismus, the primary diagnosis of dyspareunia was excluded and an expert psychologist evaluated patients and controls according to DSM IV (Diagnostic and Statistical Manual of Mental Disorders: 4th edition) criteria to exclude mental disorders. Over half (51.1%) of the patients with vaginismus were classified as alexithymic or borderline (alexithymic trend), compared with just 18% of the control group. In addition, there was a significant difference in the TAS-20 total scores between the two groups (P<0.0001). In terms of relative risk, women suffering from vaginismus thus have a 3.8 times higher probability of showing alexithymia than do healthy women. Vaginismus is a complex syndrome and alexithymia is far from being its only characteristic. However, we found a significant correlation between vaginismus and alexithymia. In theory, alexithymia could thus be a risk factor for vaginismus, although future studies are required to demonstrate any chain of causation between these two conditions.International Journal of Impotence Research advance online publication, 7 March 2013; doi:10.1038/ijir.2013.5.
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[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to investigate attachment styles in a group of women and men with sexual dysfunction. We recruited 44 subjects (21 women and 23 men) with sexual dysfunction and 41 subjects (21 women and 20 men) with healthy sexual function as the control group. Validated instruments for the evaluation of male and female sexual dysfunctions (M/F SD) and a psychometric tool specifically designed to investigate attachment style were administered. In women, significant differences were found between subjects with sexual dysfunction and healthy controls. The scales indicating an insecure attachment showed: discomfort with closeness (FSD=42.85±11.55 vs CTRL=37.38±8.54; P<0.01), relationship as secondary (FSD=26.76±2.60 vs CTRL=18.42±7.99; P<0.01), and need for approval (FSD=26.38±3.61 vs CTRL=20.76±7.36; P<0.01). Healthy women also had significantly higher scores in secure attachment (confidence: FSD=24.57±3.89 vs CTRL=33.42±5.74; P<0.01). Men with sexual dysfunctions differed from healthy men in confidence (MSD=30±6.33 vs CTRL=36.05±5.26; P<0.01) and in discomfort with closeness (MSD=39.08±8 vs CTRL=34.25±7.54; P<0.05). These results suggest that particular aspects related to insecure attachment have a determinant role in people with sexual dysfunctions. It is therefore fundamental to identify the attachment styles and relational patterns in patients receiving counselling and psychological treatments focussed on sexual problems.International Journal of Impotence Research advance online publication, 14 August 2014; doi:10.1038/ijir.2014.33.
Full-text · Article · Aug 2014 · International journal of impotence research
[Show abstract][Hide abstract] ABSTRACT: Purpose of review:
To analyze literature on sexual pain disorders and to review and summarize the articles published throughout 2013 which contribute to the current knowledge on this subject.
By age 40, 7.8% of women reported vulvar pain. Diagnostic and Statistical Manual of Mental Disorders, fifth edition, has combined vaginismus and dyspareunia into the same diagnostic label. The research reviewed in this article seems to differently point toward two conditions, focusing on different aspects both on the etiological and on the treatment area. Higher levels of partner-perceived self-efficacy and lower levels of partner catastrophizing were associated with less pain intensity in women with entry dyspareunia, independent of women's pain perception and self-efficacy. Alexithymia and fear were found to be important etiological factors in vaginismus.
The present findings did not provide clear evidence in support of the superiority of any treatment and highlight the need for randomized, placebo-controlled trials that compare treatments in the future. A lot of work remained to be done to understand such a complex and multifaceted disturbance as genital sexual pain, but the articles examined showed that we are slowly adding more knowledge on the etiological cause and treatment models for such conditions.
Full-text · Article · Sep 2014 · Current Opinion in Psychiatry
[Show abstract][Hide abstract] ABSTRACT: The assessment of sexual function is fundamental to the Assisted Reproductive Technology (ART). Nevertheless, it is still not a common clinical routine among infertility centres. The aim of this survey is to describe the main aspects of sexological screening that are considered in Italian centres of ART.
After the consensus of the Italian Society of Andrology and Sexual Medicine (SIAMS), a mailing list of reproductive medicine centres was created. Then, we sent a questionnaire concerning the essential characteristics of sexological screening. The respondents to compilers of the questionnaire sent back the information from their centres, and an analysis of absolute frequencies and percentages was performed.
First, 16 centres completed and returned the questionnaire, while 5 ignored the invitation. The main findings concerned the wide use consideration of vardenafil 10 mg (68.7 %; 11/16) for the treatment of erectile dysfunction in comorbidity with reproductive problems, the diffuse administration of International Index of Erectile Function (68.2 %; 11/16) and Structured Interview for the Erectile Dysfunction (50 %; 8/16) as psychometric tools and lesser use of Female Sexual Function Index (31.2 %; 5/16) for the evaluation of female sexuality in the infertile couple.
To conclude, we noticed a major focus on male sexuality and the eventual treatment or evaluation of sexual dysfunction compared to female sexuality. This aspect highlights an important issue for clinical practice to strongly consider and eventually reinforce. In this regard, improvement of the assessment and treatment of possible female sexual problems in reproductive medicine seems necessary.