Effects of a structured five-step hypnotherapy protocol on female sexual function in women with vaginismus: A mixed-methods pilot study

Vaginismus is a female sexual pain disorder characterized by involuntary pelvic floor muscle contractions that prevent or severely limit vaginal penetration, often leading to significant psychological distress and relational difficulties. Conventional treatments show variable effectiveness and high dropout rates, highlighting the need for integrative and patient-centered therapeutic approaches. This mixed-methods pilot study aimed to evaluate the effects of a structured five-step hypnotherapy protocol (PHSV) on female sexual function in women diagnosed with primary or secondary vaginismus. Twenty adult women (mean age = 26.0 ± 4.2 years) received an individualized hypnotherapeutic intervention delivered over a mean of 8.3 weekly sessions. The protocol combined psycho-education, Ericksonian hypnotherapy, gradual desensitization, neuro-corporeal integration, and therapeutic consolidation. Quantitative outcomes were assessed using the Female Sexual Function Index–6 items (FSFI-6), administered before and after the intervention. Qualitative data were collected through semi-structured clinical interviews, behavioral observations, and patient self-reports to explore subjective experiences of change. Results revealed a statistically significant improvement in overall sexual function, with mean FSFI-6 scores increasing from pre- to post-treatment (p < .001) and large effect sizes across all domains, particularly pain reduction and sexual satisfaction. Clinically, 80% of participants achieved successful vaginal penetration with absent or minimal pain. Qualitative findings supported these results, highlighting enhanced body awareness, reduced anticipatory anxiety, improved couple communication, and a reappropriation of sexual pleasure. Despite limitations related to sample size and the absence of a control group, findings suggest that a structured hypnotherapy protocol represents a promising, well-tolerated, and culturally adaptable intervention for vaginismus. Further controlled studies with larger samples are recommended to confirm efficacy and support protocol standardization.