Grant: Doctoral Research Award: Canada Graduate Scholarships

Background: Vaginismus is a female sexual dysfunction characterized by interference with intercourse, and is conceptualized as a specific phobia of vaginal penetration. The treatment literature reveals that many women with vaginismus do not respond to conventional interventions. However, therapist-guided gradual exposure therapy - an evidence-based intervention for phobias - has proven successful in the treatment of vaginismus. Despite this progress, institutional restrictions pose significant barriers to therapist-guided exposure. Alternative exposure-based treatments for vaginismus are therefore needed. Aim: We aim to identify components of virtual reality (VR) erotic stimuli that elicit phobic responses (fear/anxiety) in women with vaginismus, and apply these findings to develop and pilot test VR exposure therapy for vaginismus. Procedure: Women with vaginismus and controls (n = 25 per group) will use a VR headset to view 3D sexual encounters showing penetrative or non-penetrative activities either from a 1st or 3rd person point of view. Participants will provide ratings of anxiety, distress, and fear of vaginal penetration after each video. Erotic video characteristics that evoke negative affect will be identified, and these findings will inform the development of a VR intervention for vaginismus. Two groups of women with vaginismus (n = 25 per group) will be randomized to either a 3-week VR exposure therapy or an active control group involving imaginal exposure. Women will complete questionnaires assessing fear of vaginal intercourse, avoidance of sexual activity, and sexual distress before treatment, 1 week-, and 6-months following treatment. Implications: This study will be the first to examine the therapeutic potential of VR exposure therapy for vaginismus, and is likely to innovate clinical practice and improve the quality of life of women affected by this distressing health concern.