Self-diagnosing vaginismus found accurate vs health care provider diagnosis

Self-diagnosing vaginismus found accurate vs health care provider diagnosis | Image Credit: © natali_mis - © natali_mis - stock.adobe.com.

The accuracy of self-diagnosis for vaginismus using a web-based list of symptoms is similar to that of a diagnosis from a health care provider (HCP).¹

Vaginismus is s subcategory of genito-pelvic pain/penetration disorder (GPPPD), presenting as spasms of the pelvic floor muscle. A prevalence of approximately 5% to 17% has been reported among US women, though the condition is often overlooked, meaning these estimates may not reflect the true prevalence.¹

There are also potential ethnic barriers toward seeking treatment for pelvic floor disorders (PFDs).² A study was conducted in Miami, Florida, to compare PFD outcomes among Hispanic English-speaking, Hispanic Spanish-speaking, and African American women.

Participants reported their knowledge toward PFDs, including symptom burden and treatment seeking and experiences. Extremely bothersome outcomes were reported from urinary incontinence and prolapse symptoms, and many respondents had their ability to work impacted.²

Many patients were unaware of treatment options, but success was reported in most patients with prior treatment. Overall, these results highlighted the need for proper knowledge and diagnosis of urinary syndromes to improve care.²

Estimates of vaginismus may be low because of inadequate sexual health training among HCPs and reluctance among women to discuss their symptoms with their HCP. Therefore, an internet-based diagnostic tool may increase reach among women with GPPPD and improve care.¹

Improved diagnosing of sexual dysfunction, pain, and mental health disorders has been found from web-based interventions. However, data about the accuracy of these interventions toward diagnosing vaginismus remains lacking.¹

Investigators conducted a study to evaluate the accuracy of an internet-based tool for self-diagnosis vaginismus compared to clinical evaluation by an HCP. Participants included women without a prior vaginismus or GPPPD diagnosis seeking care at selected private practice sexual medicine clinics in the United States.¹

A website listing the diagnostic criteria of vaginismus was available for participants to view. After evaluating the website, participants reported their symptoms to an interviewer to receive validation for an over-the-counter vaginal dilation device used to relieve symptoms.¹

Following the self-diagnosis process, participants were diagnosed by an HCP blinded to the self-diagnosis results. The agreement between self-diagnosis and HCP diagnosis was assessed using Cohen’s Kappa coefficients to determine diagnostic concordance.¹

There were 50 participants included in the final analysis, 76% of whom self-diagnosed vaginismus. Concomitant vulvovaginal symptoms such as abnormal bleeding or skin changes were reported in 7 participants. HCP diagnosis, including a pelvic and vaginal examination, was performed in all participants.¹

An HCP diagnosed vaginismus in 92% of participants with a self-reported diagnosis. Genitourinary syndrome of menopause was diagnosed by the HCP in 1 of the 3 participants with a discordant diagnosis, while the other 2 did not have significant distress from their symptoms.¹

Only 1 of 12 participants not self-diagnosing vaginismus was diagnosed by the HCP. Significant agreement was reported between self-diagnosis and HCP diagnosis of vaginismus.¹

These results indicated accuracy of self-diagnosis vaginismus using an internet-based tool when compared to an HCP diagnosis during a clinical visit. Investigators concluded a web-based tool could shorten the time it takes for patients to be diagnosed and receive care.¹

References

1. Tuker S, Javaid S, Rubin R. Accuracy of online patient self-diagnosis of vaginismus/genito-pelvic pain/penetration. Presented at: 25th Annual Fall Scientific Meeting of SMSNA. Scottsdale, Arizona. October 17-20, 2024.
2. Krewson C. Barriers in seeking pelvic floor disorder treatment among ethnic minorities. Contemporary OB/GYN. May 8, 2024. Accessed October 15, 2024. https://www.contemporaryobgyn.net/view/barriers-in-seeking-pelvic-floor-disorder-treatment-among-ethnic-minorities