Surrogate Versus Couple Therapy in Vaginismus


Itzhak Ben-Zion, MD, Sex Clinic, Soroka Medical Center, PO Box 151 Beer-Sheva 84101, Israel. Tel: +97-28-6400678; Fax: +97-28-6400590; E-mail:


Introduction.  Women who do not have a cooperative partner cannot complete the usual therapeutic process in the treatment of vaginismus, because they cannot progress to the stage of practicing the insertion of the man partner's fingers and the insertion of a penis.

Aim.  To compare traditional couple therapy with therapy utilizing a surrogate partner.

Methods.  The study was controlled and retrospective. Data were obtained from the treatment charts of patients who had come to the clinic for treatment of vaginismus. Sixteen vaginismus patients who were treated with a man surrogate partner were compared with 16 vaginismus patients who were treated with their own partners.

Main Outcome Measures.  Successful pain-free intercourse upon completion of therapy.

Results.  One hundred percent of the surrogate patients succeeded in penile–vaginal intercourse compared with 75% in the couples group (P = 0.1). All surrogate patients ended the therapy because it was fully successful, compared with 69% in the couples group. Twelve percent of the couples group ended the therapy because it failed, and 19% because the couples decided to separate.

Conclusions.  Treating vaginismus with a man surrogate partner was at least as effective as couple therapy. Surrogate therapy may be considered for vaginismus patients who have no cooperative partner. Ben-Zion I, Rothschild S, Chudakov B, and Aloni R. Surrogate vs. couple therapy in vaginismus. J Sex Med 2007;4:728–733.