The so-called “sexual pain” disorders, vaginismus and dyspareunia, have been treated quite differently in the past. Women suffering from vaginismus were typically treated via a Masters & Johnson progressive dilatation method. Until recently, this type of treatment was considered a sex therapy success story. On the other hand, women suffering from dyspareunia, were rarely treated via sex therapy but were typically either referred for medical intervention or for treatment of a presumed underlying psychosocial cause for their pain (e.g. abuse, couple dysfunction, depression etc).
Unfortunately, both of these treatment approaches were based on theory, tradition or the prevailing influence of important clinicians rather than on data. Recent randomized controlled trials have suggested that the Masters and Johnson treatment for vaginismus is not as successful as had been thought. On the other hand, recent RCTs for the treatment of dyspareunia have suggested the CBT type treatments combining pain management and sex therapy are very useful. The future of sex therapy in the treatment of dyspareunia and vaginismus will be discussed.
