Reproduction and mode of delivery in women with vaginismus or localised provoked vestibulodynia: a Swedish register-based study

BJOG. 2015 Feb;122(3):329-34. doi: 10.1111/1471-0528.12946. Epub 2014 Jul 3.


Objective: To compare sociodemographics, parity and mode of delivery between women diagnosed with vaginismus or localised provoked vestibulodynia (LPV) to women without a diagnosis before first pregnancy.

Design: Retrospective, population-based register study.

Setting: Sweden.

Sample: All women born in Sweden 1973-83 who gave birth for the first time or remained nulliparous during the years 2001-09.

Methods: Nationally linked registries were used to identify the study population. Women diagnosed with vaginismus or LPV were compared to all other women. Odds ratios for parity and mode of delivery were calculated using multinominal regression analysis and logistic regression.

Main outcome measures: Parity and mode of delivery.

Results: Women with vaginismus/LPV were more likely to be unmarried (P = 0.001), unemployed (P = 0.012), have a higher educational level (P < 0.001), a lower body mass index (P < 0.001) and use nicotine during pregnancy (P = 0.008). They were less likely to give birth (adjusted odds ratio [OR] 0.61, 95% confidence interval [95% CI] 0.56-0.67). Women with vaginismus/LPV more often delivered by caesarean section (P < 0.001) especially for maternal request (adjusted OR 3.48, 95% CI 2.45-4.39). In women having vaginal delivery, those with vaginismus/LPV were more likely to suffer a perineal laceration (adjusted OR 1.87, 95% CI 1.56-2.25).

Conclusions: Women with vaginismus/LPV are less likely to give birth and those that do are more likely to deliver by caesarean section and have a caesarean section based upon maternal request. Those women delivering vaginally are more likely to suffer perineal laceration. These findings point to the importance of not only addressing sexual function in women with vaginismus/LPV but reproductive function as well.

Keywords: Caesarean section; localised provoked vestibulodynia; reproduction; vaginismus.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Body Mass Index
  • Cesarean Section / statistics & numerical data*
  • Delivery, Obstetric / statistics & numerical data*
  • Dyspareunia / epidemiology*
  • Dyspareunia / etiology
  • Dyspareunia / psychology
  • Educational Status
  • Female
  • Humans
  • Marital Status
  • Maternal Age
  • Obstetric Labor Complications / epidemiology*
  • Obstetric Labor Complications / etiology
  • Obstetric Labor Complications / psychology
  • Odds Ratio
  • Parity
  • Perineum / injuries*
  • Pregnancy
  • Registries
  • Retrospective Studies
  • Social Class
  • Sweden / epidemiology
  • Vaginismus / complications
  • Vaginismus / epidemiology*
  • Vaginismus / psychology
  • Vulvodynia / complications
  • Vulvodynia / epidemiology*
  • Vulvodynia / psychology