(PS10-88) Systematic Review of Effectiveness and Efficacy of Cognitive Behavioral Therapy (CBT) for Treatment of Genito-pelvic Pain/penetration Disorder (GPPPD) and Other Female Sexual Pain Disorders

Abstract

Background: The literature on cognitive behavioral therapy (CBT) as an effective and efficacious treatment for women diagnosed with female sexual pain disorders like genito-pelvic pain/penetration disorder (GPPPD) is important to provide the most updated information for developing clinical practice guidelines.  While many systematic reviews exist, there have been no systematic reviews on the effectiveness of CBT for all female sexual pain disorders. 

Objective: We review clinical intervention studies on the current literature on CBT and variations of CBT, as an effective treatment for women experiencing sexual pain, and/or diagnosed with GPPPD or a related medical diagnosis.  We also explore variations of CBT and examine whether some are more effective than others.

Method: We searched electronic databases (MEDLINE, PsycInfo, PsycArticles, SocIndex) between 29 February 2020 and 1 February 2024 for studies that tested CBT for treatment of female sexual pain disorders.  We identified eligible studies by searching electronic databases using Boolean search terms.  Outcomes of interest included: pain symptoms, sexual functioning, relational satisfaction, and quality of life. 

Results: Of all the database results, 38 articles met inclusion criteria: (i) conducted quantitative or qualitative methodology, (ii) used CBT, a variation of CBT or a combined approach with CBT, (iii) participants in the study were women (i.e., over age 16) and diagnosed with a sexual pain disorder (e.g., GPPPD, vaginismus, dyspareunia, vulvodynia, PVD, VV), (iv) the individual providing the CBT treatment had to be a PhD level psychologist, therapist, counselor or other licensed clinician, and (v) the treatment outcomes had to measure at least one psychological constructs. 

Conclusions: This systematic review provides a critical analysis of research study outcomes to explain the current state of the literature and guide future research and clinical directions.  Evidence that CBT interventions demonstrated effective and efficacious treatment of female sexual pain disorders is provided in the improved outcomes which includes an improved quality of life, as well as an enhanced relationship harmony.  Concluding remarks summarize implications for counseling professionals.  Overall, a multidisciplinary approach that includes cognitive behavioral techniques, but not discounting medical and physical treatment could prove most beneficial.

Keywords: cognitive behavioral therapy, sexual dysfunctions, female sexual pain disorder, vaginismus, dyspareunia, vulvodynia, provoked vestibulodynia, genito-pelvic pain/penetration disorder