{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T16:44:56Z","timestamp":1782751496738,"version":"3.54.5"},"reference-count":70,"publisher":"Walter de Gruyter GmbH","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Vaginismus is a condition characterized by involuntary vaginal muscle contraction leading to pain and distress that significantly impacts sexual health, psychological well-being, and quality of life. While conventional treatments, including behavioral therapy, physical therapy, and vaginal dilators, remain the cornerstone of management, their efficacy is often limited, and barriers such as stigma and access persist. Advancements such as botulinum toxin injections and topical agents show promise in reducing pain and muscle hypertonicity. Technological innovations, including laser and radiofrequency\u00a0(RF) therapy, as well as neurostimulation techniques, aim to enhance muscle relaxation and modulate nerve activity. Additionally, psychological and integrative interventions, such as virtual reality-based exposure therapy and mind-body practices, address the emotional and psychological dimensions of the condition. Advances in personalized medicine, including biomarker research, offer the potential to tailor treatments to individual patient needs. Despite these developments, challenges remain in ensuring accessibility, overcoming stigma, and conducting robust clinical trials to establish efficacy and safety. Osteopathic physicians may contribute to multidisciplinary management by addressing musculoskeletal dysfunction associated with pelvic floor disorders through osteopathic manipulative medicine (OMM). This review highlights the importance of a multidisciplinary, patient-centered approach to managing vaginismus and underscores the need for further research to refine and expand therapeutic options. A comprehensive literature search of the PubMed, JSTOR (Journal Storage), and EBSCO databases was conducted between December 2024 and August 2025, and articles were selected based on accessibility and relevance. The majority of the studies evaluated multimodal approaches, including pelvic floor physical therapy (PFPT), cognitive behavioral therapy (CBT), pharmacologic interventions, and combined strategies. Reported success rates varied widely (71\u2013100\u202f%). Newer technological advances such as laser and RF therapies, photobiomodulation (PBM), and virtual-reality therapies all found significance (p&lt;0.05) in treatment protocols and outcome definitions. Limited data were available regarding long-term outcomes, recurrence rates, and cultural\/ethnic variations. Current evidence supports a multimodal approach as the most effective strategy for managing vaginismus. However, heterogeneity in study design, diagnostic criteria, and outcome measures limits the generalizability. Standardized protocols and larger, high-quality trials are needed to improve diagnosis and optimize care for patients with vaginismus.<\/jats:p>","DOI":"10.1515\/jom-2025-0204","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T15:56:16Z","timestamp":1782748576000},"source":"Crossref","is-referenced-by-count":0,"title":["Emerging treatment options for vaginismus: a comprehensive review of current evidence and future directions"],"prefix":"10.1515","author":[{"given":"Ashley","family":"Lauver","sequence":"first","affiliation":[{"name":"Arizona College of Osteopathic Medicine , Glendale , AZ , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Addison","sequence":"additional","affiliation":[{"name":"Arizona College of Osteopathic Medicine , Glendale , AZ , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jadyn","family":"Anderson","sequence":"additional","affiliation":[{"name":"Arizona College of Osteopathic Medicine , Glendale , AZ , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"BreAnna","family":"Boyle","sequence":"additional","affiliation":[{"name":"Arizona College of Osteopathic Medicine , Glendale , AZ , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halley","family":"McDonald","sequence":"additional","affiliation":[{"name":"Arizona College of Osteopathic Medicine , Glendale , AZ , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Arizona College of Osteopathic Medicine , Glendale , AZ , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Schraml","sequence":"additional","affiliation":[{"name":"Arizona College of Osteopathic Medicine , Glendale , AZ , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinne","family":"Jedynak-Bell","sequence":"additional","affiliation":[{"name":"Arizona College of Osteopathic Medicine , Glendale , AZ , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trina","family":"Mansour","sequence":"additional","affiliation":[{"name":"Department of Gynecology , US Department of Veterans Affair , Phoenix , AZ , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Ashurst","sequence":"additional","affiliation":[{"name":"Arizona College of Osteopathic Medicine , Glendale , AZ , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"2026062915561389651_j_jom-2025-0204_ref_001","doi-asserted-by":"crossref","unstructured":"Kadir, ZS, Sidi, H, Kumar, J, Das, S, Midin, M, Baharuddin, N. The neurobiology and psychiatric perspective of vaginismus: linking the pharmacological and psycho-social interventions. Curr Drug Targets 2018;19:916\u201326. https:\/\/doi.org\/10.2174\/1389450118666170222153908.","DOI":"10.2174\/1389450118666170222153908"},{"key":"2026062915561389651_j_jom-2025-0204_ref_002","unstructured":"Quinlan, JD. Genito-pelvic pain\/penetration disorder (vaginismus). In: Domino, FJF, Baldor, RAR, Golding, JJ, et al., editors. 5-minute clinical consult. Wolters Kluwer; 2026. https:\/\/im.unboundmedicine.com\/medicine\/view\/5-Minute-Clinical-Consult\/816419\/2\/Genito_Pelvic_Pain_Penetration_Disorder__Vaginismus [Accessed 8 Aug 2025]."},{"key":"2026062915561389651_j_jom-2025-0204_ref_003","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed. American Psychiatric Association; 2013: Sexual Dysfunctions.","DOI":"10.1176\/appi.books.9780890425596"},{"key":"2026062915561389651_j_jom-2025-0204_ref_004","doi-asserted-by":"crossref","unstructured":"American College of Obstetricians and Gynecologists\u2019 Committee on Practice Bulletins\u2014Gynecology. Female Sexual Dysfunction: ACOG Practice Bulletin Clinical Management Guidelines for Obstetrician-Gynecologists, Number 213. Obstet Gynecol 2019;134:e1-18. https:\/\/doi.org\/10.1097\/aog.0000000000003324.","DOI":"10.1097\/AOG.0000000000003324"},{"key":"2026062915561389651_j_jom-2025-0204_ref_005","doi-asserted-by":"crossref","unstructured":"Pacik, PT. Understanding and treating vaginismus: a multimodal approach. Int UrogynEcol J 2014;25:1613\u201320. https:\/\/doi.org\/10.1007\/s00192-014-2421-y.","DOI":"10.1007\/s00192-014-2421-y"},{"key":"2026062915561389651_j_jom-2025-0204_ref_006","doi-asserted-by":"crossref","unstructured":"Jeng, CJ. The pathophysiology and etiology of vaginismus. Taiwan J Obstet Gynecol 2004;43:10\u201315. https:\/\/doi.org\/10.1016\/s1028-4559(09)60047-4.","DOI":"10.1016\/S1028-4559(09)60047-4"},{"key":"2026062915561389651_j_jom-2025-0204_ref_007","doi-asserted-by":"crossref","unstructured":"Reissing, ED, Binik, YM, Khalif\u00e9, S, Cohen, D, Amsel, R. Vaginal spasm, pain, and behavior: an empirical investigation of the diagnosis of vaginismus. Arch Sex Behav 2004;33:5\u201317. https:\/\/doi.org\/10.1023\/b:aseb.0000007458.32852.c8.","DOI":"10.1023\/B:ASEB.0000007458.32852.c8"},{"key":"2026062915561389651_j_jom-2025-0204_ref_008","doi-asserted-by":"crossref","unstructured":"Lahaie, MA, Boyer, SC, Amsel, R, Khalif\u00e9, S, Binik, YM. Vaginismus: a review of the literature on the classification\/diagnosis, etiology and treatment. Women\u2019s Health. 2010;6:705\u201319. https:\/\/doi.org\/10.2217\/whe.10.46.","DOI":"10.2217\/WHE.10.46"},{"key":"2026062915561389651_j_jom-2025-0204_ref_009","doi-asserted-by":"crossref","unstructured":"Brotto, LA, Atallah, S, Carvalho, J, Gordon, E, Pascoal, PM, Reda, M, et al.. Psychological and interpersonal dimensions of sexual function and dysfunction: recommendations from the fifth international consultation on sexual medicine (ICSM 2024). Sex Med Rev 2024;13:118\u201343. https:\/\/doi.org\/10.1093\/sxmrev\/qeae073.","DOI":"10.1093\/sxmrev\/qeae073"},{"key":"2026062915561389651_j_jom-2025-0204_ref_010","doi-asserted-by":"crossref","unstructured":"Turan, \u015e, Usta Sa\u011flam, NG, Bakay, H, G\u00f6kler, ME. Levels of depression and anxiety, sexual functions, and affective temperaments in women with lifelong vaginismus and their male partners. J\u00a0Sex Med 2020;17:2434\u201345. https:\/\/doi.org\/10.1016\/j.jsxm.2020.08.018.","DOI":"10.1016\/j.jsxm.2020.08.018"},{"key":"2026062915561389651_j_jom-2025-0204_ref_011","doi-asserted-by":"crossref","unstructured":"Pithavadian, R, Dune, T, Chalmers, J, Ramanathan, V. The interrelationship between women\u2019s help-seeking experiences for vaginismus and their sense of self: a qualitative study and abductive analysis. Health Psychol Behav Med 2024;12:1\u201324. https:\/\/doi.org\/10.1080\/21642850.2024.2396134.","DOI":"10.1080\/21642850.2024.2396134"},{"key":"2026062915561389651_j_jom-2025-0204_ref_012","doi-asserted-by":"crossref","unstructured":"ter Kuile, MM, van Lankveld, JJDM, de Groot, E, Melles, R, Neffs, J, Zandbergen, M. Cognitive-behavioral therapy for women with lifelong vaginismus: process and prognostic factors. Behav Res Ther 2007;45:359\u201373. https:\/\/doi.org\/10.1016\/j.brat.2006.03.013.","DOI":"10.1016\/j.brat.2006.03.013"},{"key":"2026062915561389651_j_jom-2025-0204_ref_013","doi-asserted-by":"crossref","unstructured":"van Lankveld, JJDM, ter Kuile, MM, de Groot, HE, Melles, R, Nefs, J, Zandbergen, M. Cognitive-behavioral therapy for women with lifelong vaginismus: a randomized waiting-list controlled trial of efficacy. J\u00a0Consult Clin Psychol 2006;74:168\u201378. https:\/\/doi.org\/10.1037\/0022-006x.74.1.168.","DOI":"10.1037\/0022-006X.74.1.168"},{"key":"2026062915561389651_j_jom-2025-0204_ref_014","doi-asserted-by":"crossref","unstructured":"Kabak\u00e7i, E, Batur, S. Who benefits from cognitive behavioral therapy for vaginismus? J\u00a0Sex Marital Ther 2003;29:277\u201388. https:\/\/doi.org\/10.1080\/00926230390195515.","DOI":"10.1080\/00926230390195515"},{"key":"2026062915561389651_j_jom-2025-0204_ref_015","doi-asserted-by":"crossref","unstructured":"McEvoy, M, McElvaney, R, Glover, R. Understanding vaginismus: a biopsychosocial perspective. Sex Relatsh Ther 2021;39:1\u201322. https:\/\/doi.org\/10.1080\/14681994.2021.2007233.","DOI":"10.1080\/14681994.2021.2007233"},{"key":"2026062915561389651_j_jom-2025-0204_ref_016","doi-asserted-by":"crossref","unstructured":"Gupta, A, Kansal, S, Gupta, N. \u201cCommon sense\u201d approach to the management of vaginismus: a case series. J\u00a0Psychosexual Health 2020;2:186\u20139. https:\/\/doi.org\/10.1177\/2631831820934989.","DOI":"10.1177\/2631831820934989"},{"key":"2026062915561389651_j_jom-2025-0204_ref_017","doi-asserted-by":"crossref","unstructured":"Reissing, ED, Armstrong, HL, Allen, C. Pelvic floor physical therapy for lifelong vaginismus: a retrospective chart review and interview study. J\u00a0Sex Marital Ther 2013;39:306\u201320. https:\/\/doi.org\/10.1080\/0092623x.2012.697535.","DOI":"10.1080\/0092623X.2012.697535"},{"key":"2026062915561389651_j_jom-2025-0204_ref_018","doi-asserted-by":"crossref","unstructured":"Wallace, SL, Miller, LD, Mishra, K. Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women. Curr Opin Obstet Gynecol 2019;31:485\u201393. https:\/\/doi.org\/10.1097\/gco.0000000000000584.","DOI":"10.1097\/GCO.0000000000000584"},{"key":"2026062915561389651_j_jom-2025-0204_ref_019","doi-asserted-by":"crossref","unstructured":"Fisher, KA. Management of dyspareunia and associated levator ani muscle overactivity. Phys Ther 2007;87:935\u201341. https:\/\/doi.org\/10.2522\/ptj.20060168.","DOI":"10.2522\/ptj.20060168"},{"key":"2026062915561389651_j_jom-2025-0204_ref_020","doi-asserted-by":"crossref","unstructured":"Seo, JT, Choe, JH, Lee, WS, Kim, KH. Efficacy of functional electrical stimulation-biofeedback with sexual cognitive-behavioral therapy as treatment of vaginismus. Urology 2005;66:77\u201381. https:\/\/doi.org\/10.1016\/j.urology.2005.01.025.","DOI":"10.1016\/j.urology.2005.01.025"},{"key":"2026062915561389651_j_jom-2025-0204_ref_021","doi-asserted-by":"crossref","unstructured":"American College of Obstetricians and Gynecologists\u2019 Committee on Practice Bulletins-Gynecology. Chronic Pelvic Pain: ACOG Practice Bulletin, Number 218. Obstet Gynecol 2020;135:e98\u2013109. https:\/\/doi.org\/10.1097\/aog.0000000000003716.","DOI":"10.1097\/AOG.0000000000003716"},{"key":"2026062915561389651_j_jom-2025-0204_ref_022","doi-asserted-by":"crossref","unstructured":"American College of Obstetricians and Gynecologists\u2019 Committee on Patient Safety and Quality Improvement. Committee Opinion No. 674: Guiding Principles for Privileging of Innovative Procedures in Gynecologic Surgery. Obstet Gynecol 2016;128:e85\u201388. https:\/\/doi.org\/10.1097\/aog.0000000000001646.","DOI":"10.1097\/AOG.0000000000001646"},{"key":"2026062915561389651_j_jom-2025-0204_ref_023","doi-asserted-by":"crossref","unstructured":"Danielsson, I, Torstensson, T, Brodda-Jansen, G, Bohm-Starke, N. EMG biofeedback versus topical lidocaine gel: a randomized study for the treatment of women with vulvar vestibulitis. Acta Obstet Gynecol Scand 2006;85:1360\u20137. https:\/\/doi.org\/10.1080\/00016340600883401.","DOI":"10.1080\/00016340600883401"},{"key":"2026062915561389651_j_jom-2025-0204_ref_024","doi-asserted-by":"crossref","unstructured":"Hassel, B. Resolution of primary vaginismus and introital hyperesthesia by topical anesthesia. Anesth Analg 1997;85:1415\u201316. https:\/\/doi.org\/10.1097\/00000539-199712000-00055.","DOI":"10.1213\/00000539-199712000-00055"},{"key":"2026062915561389651_j_jom-2025-0204_ref_025","doi-asserted-by":"crossref","unstructured":"Peleg, R, Press, Y, Ben-Zion, IZ. Glyceryl trinitrate ointment as a potential treatment for primary vaginismus. Eur J Obstet Gynecol Reprod Biol 2001;96:111\u201312. https:\/\/doi.org\/10.1016\/s0301-2115(00)00378-x.","DOI":"10.1016\/S0301-2115(00)00378-X"},{"key":"2026062915561389651_j_jom-2025-0204_ref_026","doi-asserted-by":"crossref","unstructured":"Sawan, D, Almanasif, M, Alharshan, S, Alanazi, R, Fallatah, S, Alanazi, W, et al.. Efficacy of intra-vaginal diazepam for pelvic floor hypertonic disorder: a systematic review and meta-analysis. Cont Rep 2025;15:100087. https:\/\/doi.org\/10.1016\/j.contre.2025.100087.","DOI":"10.1016\/j.contre.2025.100087"},{"key":"2026062915561389651_j_jom-2025-0204_ref_027","doi-asserted-by":"crossref","unstructured":"Brin, MF. Botulinum toxin: chemistry, pharmacology, toxicity, and immunology. Muscle Nerve Suppl 1997;6:S146\u201368. https:\/\/doi.org\/10.1002\/(sici)1097-4598(1997)6+<146::aid-mus10>3.0.co;2-4.","DOI":"10.1002\/(SICI)1097-4598(1997)6+<146::AID-MUS10>3.0.CO;2-4"},{"key":"2026062915561389651_j_jom-2025-0204_ref_028","doi-asserted-by":"crossref","unstructured":"Ghazizadeh, S, Nikzad, M. Botulinum toxin in the treatment of refractory vaginismus. Obstet Gynecol. 2004;104:922\u20135. https:\/\/doi.org\/10.1097\/01.aog.0000141441.41178.6b.","DOI":"10.1097\/01.AOG.0000141441.41178.6b"},{"key":"2026062915561389651_j_jom-2025-0204_ref_029","doi-asserted-by":"crossref","unstructured":"Moga, M, Dimienescu, O, B\u0103lan, A, Sc\u00e2rneciu, I, Baraba\u015f, B, Ple\u015f, L. Therapeutic approaches of botulinum toxin in gynecology. Toxins 2018;10:169. https:\/\/doi.org\/10.3390\/toxins10040169.","DOI":"10.3390\/toxins10040169"},{"key":"2026062915561389651_j_jom-2025-0204_ref_030","doi-asserted-by":"crossref","unstructured":"Pacik, PT, Geletta, S. Vaginismus treatment: clinical trials follow up 241 patients. Sex Med 2017;5:e114\u201323. https:\/\/doi.org\/10.1016\/j.esxm.2017.02.002.","DOI":"10.1016\/j.esxm.2017.02.002"},{"key":"2026062915561389651_j_jom-2025-0204_ref_031","doi-asserted-by":"crossref","unstructured":"Velayati, A, Jahanian Sadatmahalleh, S, Ziaei, S, Kazemnejad, A. Can botox offer help women with vaginismus? A systematic review and meta-analysis. Int J Sex Health 2019;31:233\u201343. https:\/\/doi.org\/10.1080\/19317611.2019.1616029.","DOI":"10.1080\/19317611.2019.1616029"},{"key":"2026062915561389651_j_jom-2025-0204_ref_032","doi-asserted-by":"crossref","unstructured":"Helmi, ZR. Comparative study of 150 vs. 200 units of botulinum toxin as treatment for vaginismus. Rev Bras Ginecol Obstet\/RBGO Gynecol Obstet 2022;44:854\u201365. https:\/\/doi.org\/10.1055\/s-0042-1751287.","DOI":"10.1055\/s-0042-1751287"},{"key":"2026062915561389651_j_jom-2025-0204_ref_033","unstructured":"Desai, SA, Shah, B, Kroumpouzos, G. Botulinum toxin treatment of refractory vaginismus: a prospective study. Int J Womens Dermatol 2024;10:e186\u20136. https:\/\/doi.org\/10.1097\/jw9.0000000000000186."},{"key":"2026062915561389651_j_jom-2025-0204_ref_034","doi-asserted-by":"crossref","unstructured":"Bartley, J, Han, E, Gupta, P, Gaines, N, Killinger, KA, Boura, JA, et al.. Transvaginal trigger point injections improve pain scores in women with pelvic floor hypertonicity and pelvic pain conditions. Female Pelvic Med Reconstr Surg 2019;25:392\u20136. https:\/\/doi.org\/10.1097\/spv.0000000000000581.","DOI":"10.1097\/SPV.0000000000000581"},{"key":"2026062915561389651_j_jom-2025-0204_ref_035","doi-asserted-by":"crossref","unstructured":"Fouad, L, Chen, A, Pettit, P, Micallef, A. Transvaginal trigger point injections for pelvic floor myofascial spasm: a retrospective review of pain assessment and development of a treatment algorithm. J\u00a0Minim Invasive Gynecol 2015;22:S247\u20138. https:\/\/doi.org\/10.1016\/j.jmig.2015.08.864.","DOI":"10.1016\/j.jmig.2015.08.864"},{"key":"2026062915561389651_j_jom-2025-0204_ref_036","unstructured":"Article\u00a0\u2013\u00a0billing and coding: trigger point injections (TPI) (A59480). Cms.gov; 2025. https:\/\/www.cms.gov\/medicare-coverage-database\/view\/article.aspx?articleid=59480&ver=9&utm [Accessed 20 Nov 2025]."},{"key":"2026062915561389651_j_jom-2025-0204_ref_037","doi-asserted-by":"crossref","unstructured":"Ruffini, N, D\u2019Alessandro, G, Cardinali, L, Frondaroli, F, Cerritelli, F. Osteopathic manipulative treatment in gynecology and obstetrics: a systematic review. Complement Ther Med 2016;26:72\u20138. https:\/\/doi.org\/10.1016\/j.ctim.2016.03.005.","DOI":"10.1016\/j.ctim.2016.03.005"},{"key":"2026062915561389651_j_jom-2025-0204_ref_038","doi-asserted-by":"crossref","unstructured":"Barnett, ME, Henderson, KK, Elliott-Burke, TL, Heinking, KP. Osteopathic manipulative treatment of chronic pelvic pain due to high-tone pelvic floor dysfunction. Osteopathic Family Physician 2023;15:12\u201318. https:\/\/doi.org\/10.33181\/13095.","DOI":"10.33181\/13095"},{"key":"2026062915561389651_j_jom-2025-0204_ref_039","doi-asserted-by":"crossref","unstructured":"Molins-Cubero, S, Rodr\u00edguez-Blanco, C, Oliva-Pascual-Vaca, A, Heredia-Rizo, AM, Bosc\u00e1-Gand\u00eda, JJ, Ricard, F. Changes in pain perception after pelvis manipulation in women with primary dysmenorrhea: a randomized controlled trial. Pain Med 2014;15:1455\u201363. https:\/\/doi.org\/10.1111\/pme.12404.","DOI":"10.1111\/pme.12404"},{"key":"2026062915561389651_j_jom-2025-0204_ref_040","unstructured":"Su, X, Liu, J, Yang, H, Chen, H, Yin, X, Gu, D, et al.. Observations on the therapeutic efficacy of biomimetic physiotherapy combined with manipulation therapy in managing myofascial pelvic pain syndrome in women. Altern Ther Health Med 2024;30:162\u20137."},{"key":"2026062915561389651_j_jom-2025-0204_ref_041","doi-asserted-by":"crossref","unstructured":"Preti, M, Vieira-Baptista, P, Digesu, GA, Bretschneider, CE, Damaser, M, Demirkesen, O, et al.. The clinical role of LASER for vulvar and vaginal treatments in gynaecology and female urology: a best practice document. J\u00a0Low Genit Tract Dis 2019;23:151\u201360. https:\/\/doi.org\/10.1097\/LGT.0000000000000462.","DOI":"10.1097\/LGT.0000000000000462"},{"key":"2026062915561389651_j_jom-2025-0204_ref_042","doi-asserted-by":"crossref","unstructured":"Li, D, Li, M, Wu, G, Wu, L, Ma, Y, Zhang, X. Evaluating the effectiveness of radiofrequency therapy and manual pelvic fascial release in treating myofascial pelvic pain. Int UrogynEcol J 2024;35:1219\u201325. https:\/\/doi.org\/10.1007\/s00192-024-05763-x.","DOI":"10.1007\/s00192-024-05763-x"},{"key":"2026062915561389651_j_jom-2025-0204_ref_043","doi-asserted-by":"crossref","unstructured":"Rocha-Rangel, SC, Pereira, GMV, Juliato, CRT, Brito, LGO. Laser and pelvic floor muscle training for urinary incontinence: a randomized clinical trial. Urogynecology 2024;31:627\u201335. https:\/\/doi.org\/10.1097\/SPV.0000000000001516.","DOI":"10.1097\/SPV.0000000000001516"},{"key":"2026062915561389651_j_jom-2025-0204_ref_044","doi-asserted-by":"crossref","unstructured":"Gaspar, A, Addamo, G, Brandi, H. Vaginal fractional CO2 laser: a minimally invasive option for vaginal rejuvenation. Am J Cosmet Surg 2011;28:156\u201362. https:\/\/doi.org\/10.5992\/0748-8068-28.3.156.","DOI":"10.1177\/074880681102800309"},{"key":"2026062915561389651_j_jom-2025-0204_ref_045","doi-asserted-by":"crossref","unstructured":"de Carvalho, JCGR, Agualusa, LM, Moreira, LMR, da Costa, JCM. Terap\u00eautica multimodal do vaginismo: abordagem inovadora por meio de infiltra\u00e7\u00e3o de pontos gatilho e radiofrequ\u00eancia pulsada do nervo pudendo. Braz J Anesthesiol 2017;67:632\u20136. https:\/\/doi.org\/10.1016\/j.bjan.2014.10.005.","DOI":"10.1016\/j.bjan.2014.10.005"},{"key":"2026062915561389651_j_jom-2025-0204_ref_046","unstructured":"U.S. Food and Drug Administration. FDA warns against use of energy-based devices to perform vaginal \u201crejuvenation\u201d or vaginal cosmetic procedures. Safety communication [PDF]. Silver Spring: U.S. Department of Health and Human Services; 2018 [Accessed 11 Nov 2025]."},{"key":"2026062915561389651_j_jom-2025-0204_ref_047","doi-asserted-by":"crossref","unstructured":"The North American Menopause Society. The 2020 genitourinary syndrome of menopause position statement of the North American Menopause Society. Menopause 2020;27:976\u201392. https:\/\/doi.org\/10.1097\/GME.0000000000001609.","DOI":"10.1097\/GME.0000000000001609"},{"key":"2026062915561389651_j_jom-2025-0204_ref_048","doi-asserted-by":"crossref","unstructured":"Kaufman, MR, Ackerman, AL, Amin, KA, Coffey, M, Danan, E, Faubion, SS, et al.. The AUA\/SUFU\/AUGS guideline on genitourinary syndrome of menopause. J\u00a0Urol 2025;214:242\u201350. https:\/\/doi.org\/10.1097\/ju.0000000000004589.","DOI":"10.1097\/JU.0000000000004589"},{"key":"2026062915561389651_j_jom-2025-0204_ref_049","doi-asserted-by":"crossref","unstructured":"Kohli, N, Jarnagin, B, Stoehr, AR, Lamvu, G. An observational cohort study of pelvic floor photobiomodulation for treatment of chronic pelvic pain. J\u00a0Comp Eff Res 2021;10:1291\u20139. https:\/\/doi.org\/10.2217\/cer-2021-0187.","DOI":"10.2217\/cer-2021-0187"},{"key":"2026062915561389651_j_jom-2025-0204_ref_050","doi-asserted-by":"crossref","unstructured":"Banakhar, MA, Youness, A. Sacral neuromodulation for lower urinary tract symptoms: effect of therapy on Saudi patient sexual function. Sex Med 2021;9:100388. https:\/\/doi.org\/10.1016\/j.esxm.2021.100388.","DOI":"10.1016\/j.esxm.2021.100388"},{"key":"2026062915561389651_j_jom-2025-0204_ref_051","doi-asserted-by":"crossref","unstructured":"Shaza, K, Soh, SE, Morin, M, Schneider, M, Heron, E, Frawley, H. Is there a difference in pelvic floor muscle tone between women with and without pelvic pain? A systematic review and meta-analysis. J\u00a0Sex Med 2023;20:65\u201396. https:\/\/doi.org\/10.1093\/jsxmed\/qdac002.","DOI":"10.1093\/jsxmed\/qdac002"},{"key":"2026062915561389651_j_jom-2025-0204_ref_052","doi-asserted-by":"crossref","unstructured":"Terzoni, S, Mora, C, Cloconi, C, Gaia, G, Sighinolfi, MC, Maruccia, S, et al.. Transcutaneous electrical nerve stimulation for pelvic pain: a scoping review of treatment protocols, practical indications, and caveats. Neurourol Urodyn 2023;42:631\u201340. https:\/\/doi.org\/10.1002\/nau.25137.","DOI":"10.1002\/nau.25137"},{"key":"2026062915561389651_j_jom-2025-0204_ref_053","doi-asserted-by":"crossref","unstructured":"Mondaini, N, Gacci, M, Cai, T, Lotti, F, Li Marzi, V, Crocerossa, F, et al.. Electromagnetic stimulation to reduce the hypertonia of the pelvic floor muscles and improve chronic pelvic pain in women. Arch Ital Urol Androl 2024;96:12623. https:\/\/doi.org\/10.4081\/aiua.2024.12623.","DOI":"10.4081\/aiua.2024.12623"},{"key":"2026062915561389651_j_jom-2025-0204_ref_054","doi-asserted-by":"crossref","unstructured":"Yaraghi, M, Ghazizadeh, S, Mohammadi, F, Ashtiani, EM, Bakhtiyari, M, Mareshi, SM, et al.. Comparing the effectiveness of functional electrical stimulation via sexual cognitive\/behavioral therapy of pelvic floor muscles versus local injection of botulinum toxin on the sexual functioning of patients with primary vaginismus: a randomized clinical trial. Int UrogynEcol J 2018;30:1821\u20138. https:\/\/doi.org\/10.1007\/s00192-018-3836-7.","DOI":"10.1007\/s00192-018-3836-7"},{"key":"2026062915561389651_j_jom-2025-0204_ref_055","doi-asserted-by":"crossref","unstructured":"Barba, M, Cola, A, De Vicari, D, Costa, C, La Greca, G, Vigna, A, et al.. Changes in pelvic floor ultrasonographic features after flat magnetic stimulation in women with chronic pelvic pain and levator ani muscle hypertonicity. Medicina 2024;60:374. https:\/\/doi.org\/10.3390\/medicina60030374.","DOI":"10.3390\/medicina60030374"},{"key":"2026062915561389651_j_jom-2025-0204_ref_056","doi-asserted-by":"crossref","unstructured":"Desrochers, G, Bergeron, S, Khalif\u00e9, S, Dupuis, MJ, Jodoin, M. Fear avoidance and self-efficacy in relation to pain and sexual impairment in women with provoked Vestibulodynia. Clin J Pain 2009;25:520\u20137. https:\/\/doi.org\/10.1097\/ajp.0b013e31819976e3.","DOI":"10.1097\/AJP.0b013e31819976e3"},{"key":"2026062915561389651_j_jom-2025-0204_ref_057","doi-asserted-by":"crossref","unstructured":"Brown, NB, Milani, S, Jabs, F, Kingstone, A, Brotto, LA. Exploring women\u2019s state-level anxiety in response to virtual reality erotica. J\u00a0Sex Marital Ther 2023;50:137\u201351. https:\/\/doi.org\/10.1080\/0092623x.2023.2265924.","DOI":"10.1080\/0092623X.2023.2265924"},{"key":"2026062915561389651_j_jom-2025-0204_ref_058","doi-asserted-by":"crossref","unstructured":"Lafortune, D, Lapointe, VA, Dub\u00e9, S, Brotto, LA. Virtual reality therapy for sexual dysfunctions: a scoping review. Curr Sex Health Rep 2023;15:261\u201379. https:\/\/doi.org\/10.1007\/s11930-023-00374-x.","DOI":"10.1007\/s11930-023-00374-x"},{"key":"2026062915561389651_j_jom-2025-0204_ref_059","doi-asserted-by":"crossref","unstructured":"Opri\u015f, D, Pintea, S, Garc\u00eda-Palacios, A, Botella, C, Szamosk\u00f6zi, \u015e, David, D. Virtual reality exposure therapy in anxiety disorders: a quantitative meta-analysis. Depress Anxiety 2011;29:85\u201393. https:\/\/doi.org\/10.1002\/da.20910.","DOI":"10.1002\/da.20910"},{"key":"2026062915561389651_j_jom-2025-0204_ref_060","doi-asserted-by":"crossref","unstructured":"Bishop, SR, Lau, M, Shapiro, S, Carlson, L, Anderson, ND, Carmody, J, et al.. Mindfulness: a proposed operational definition. Clin Psychol Sci Pract 2004;11:230\u201341. https:\/\/doi.org\/10.1093\/clipsy\/bph077.","DOI":"10.1093\/clipsy.bph077"},{"key":"2026062915561389651_j_jom-2025-0204_ref_061","doi-asserted-by":"crossref","unstructured":"Jokar, F, Fani, M, Isfahani, NT, Sabahi, R. Effectiveness of biofeedback with dilator therapy for sexual function in women with primary vaginismus: randomized controlled trial study. Int UrogynEcol J 2024;36. https:\/\/doi.org\/10.1007\/s00192-02406011-y.","DOI":"10.1007\/s00192-024-06011-y"},{"key":"2026062915561389651_j_jom-2025-0204_ref_062","unstructured":"Tabatabaie, NS, Rasti Borujeni, F, Tavakol, Z, Raeisi Shahraki, H. The effect of yoga and pelvic floor muscle exercise on sexual function and sexual self-esteem of reproductive-age women: a randomized clinical trial. Int J Community Based Nurs Midwifery 2024;12:188\u201398. https:\/\/doi.org\/10.30476\/IJCBNM.2024.101743.2441."},{"key":"2026062915561389651_j_jom-2025-0204_ref_063","unstructured":"\u00d6zdel, K, Y\u0131lmaz \u00d6zpolat, A, \u00c7eri, \u00d6, Kumbasar, H. Factors that might be predictive of completion of vaginismus treatment. T\u00fcrk Psikiyatri Derg 2012;23:248\u201353."},{"key":"2026062915561389651_j_jom-2025-0204_ref_064","doi-asserted-by":"crossref","unstructured":"Konkan, R, Bayrak, M, G\u00f6n\u00fcll\u00fc, OG, \u015eenormanci, \u00d6, Sungur, MZ. Vajinusmuslu Kad\u0131nlarda Cinsel \u0130\u015flev Ve Doyum\/sexual function and satisfaction of women with vaginismus. D\u00fc\u015f\u00fcnen Adam J Psychiatr Neurol Sci 2012;25:305\u201311. https:\/\/doi.org\/10.5350\/dajpn2012250402.","DOI":"10.5350\/DAJPN2012250402"},{"key":"2026062915561389651_j_jom-2025-0204_ref_065","doi-asserted-by":"crossref","unstructured":"Kiremitli, S, Kiremitli, T. Examination of treatment duration, treatment success and obstetric results according to the vaginismus grades. Sex Med 2021;9:100407. https:\/\/doi.org\/10.1016\/j.esxm.2021.100407.","DOI":"10.1016\/j.esxm.2021.100407"},{"key":"2026062915561389651_j_jom-2025-0204_ref_066","doi-asserted-by":"crossref","unstructured":"Velten, J, Margraf, J. Exploring barriers and facilitators to women\u2019s intention and behavior to seek treatment for distressing sexual problems. PLoS One 2023;18:e0288205. https:\/\/doi.org\/10.1371\/journal.pone.0288205.","DOI":"10.1371\/journal.pone.0288205"},{"key":"2026062915561389651_j_jom-2025-0204_ref_067","doi-asserted-by":"crossref","unstructured":"Hubbard, AK, Anderson, JR. Understanding barriers to couples therapy. J\u00a0Marital Fam Ther 2022;48. https:\/\/doi.org\/10.1111\/jmft.12589.","DOI":"10.1111\/jmft.12589"},{"key":"2026062915561389651_j_jom-2025-0204_ref_068","doi-asserted-by":"crossref","unstructured":"Banaei, M, Kariman, N, Ozgoli, G, Nasiri, M. Bio-psychosocial factor of vaginismus in Iranian women. Reprod Health 2021;18. https:\/\/doi.org\/10.1186\/s12978-021-01260-2.","DOI":"10.1186\/s12978-021-01260-2"},{"key":"2026062915561389651_j_jom-2025-0204_ref_069","doi-asserted-by":"crossref","unstructured":"Yasan, A, Akdeniz, N. Treatment of lifelong vaginismus in traditional Islamic couples: a prospective study. J\u00a0Sex Med 2009;6:1054\u201361. https:\/\/doi.org\/10.1111\/j.1743-6109.2008.01154.x.","DOI":"10.1111\/j.1743-6109.2008.01154.x"},{"key":"2026062915561389651_j_jom-2025-0204_ref_070","doi-asserted-by":"crossref","unstructured":"ter Kuile, MM, Melles, R, de Groot, HE, Tuijnman-Raasveld, CC, van Lankveld, JJDM. Therapist-aided exposure for women with lifelong vaginismus: a randomized waiting-list control trial of efficacy. J\u00a0Consult Clin Psychol 2013;81:1127\u201336. https:\/\/doi.org\/10.1037\/a0034292.","DOI":"10.1037\/a0034292"}],"container-title":["Journal of Osteopathic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jom-2025-0204\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jom-2025-0204\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T15:58:00Z","timestamp":1782748680000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jom-2025-0204\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,30]]},"references-count":70,"alternative-id":["10.1515\/jom-2025-0204"],"URL":"https:\/\/doi.org\/10.1515\/jom-2025-0204","relation":{},"ISSN":["2702-3648"],"issn-type":[{"value":"2702-3648","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,30]]}}}