Grant: Project Grant

Background: Vaginismus is a condition of involuntary tightening of the pelvic floor muscles that prevents vaginal intercourse and pap screening and is best conceptualized as a phobia of vaginal penetration. The most effective treatment for Vaginismus is exposure therapy, in which the person inserts dilators into their own vagina, in the presence of a clinician. Since this treatment is not available in Canada, it leaves many women with Vaginismus without appropriate care. Virtual reality exposure (VRE) immerses individuals in a 3D environment where their feared situation is displayed, and they can overcome their fear by being immersed in the virtual scene. Our team has collected pilot data showing that VRE for Vaginismus holds potential as an acceptable, effective, innovative treatment. Aim: to test the effectiveness of a novel VRE treatment for Vaginismus. Objectives: We will examine whether VRE for Vaginismus improves: (1) a person's ease of having vaginal insertion, (2) insertion pain, (3) sexual activity that includes penetration, (4) penetration-related thoughts, and (5) sex-related distress. Research plan: We will use a study design in which participants' improvement with VRE will be compared to how they were at baseline with no VRE over the course of 24 weeks. Before testing, each participant will have an educational session via Zoom where the study therapist will explain the treatment rationale. All VRE testing will take place in a private research hospital room. After the VRE session, participants will self-insert vaginal dilators 3 times per week at home. Outcomes: All self-report measures will be completed online. In addition, they will rate how easy it is to insert the vaginal dilator, and all measures will be given at the beginning of the no-VRE testing, immediately after VRE testing, and 3- and 6-months later. Implications: This project lays the foundation to improve interventions for Vaginismus using an innovative virtual reality program.