The focus of this research database is on how stress affects women's health,

and options for treatment using mind-body therapies. 

If you are not a health care professional, see new "Medical Glossary" below.  

To obtain full summaries of the articles, see "How to Get Abstracts" below. 

Review of appropriate questions to ask and how to conduct a thorough exam to aid in the diagnosis and treatment of causes of dyspareunia. Causes can include hormonal, inflammatory, muscular, iatrogenic, neurologic, vascular, connective and immune, as well as psychosexual factors.

2001 J Sex Marital Ther 27;5:489-501

Graziottin, A.

8115091 R,T

Review of literature, etiologies, exam and treatment for dyspareunia. Reminder that secondary sexual dysfunction can arise from an initial simple organic problem.

1993 Obstet Gynecol Clin North Am 20;4:779-93

Steege, J. F. and Ling, F. W.

10581978 JA

Of 100 women with dyspareunia seen because they did not feel their problem had been adequately addressed by their health professionals, 66 attributed their pain to physical causes, and 34 to psychosocial causes (such as anxiety or relationship problems). Those who attributed psychosocial causes had significantly more pain, marital problems and history of sexual assault.

1999 Psychosomatics 40;6:497-502

Meana, M., Binik, Y. M., Khalife, S., and Cohen, D.

6525355 JA

Small study showing that biofeedback could successfully treat vaginismus, and worked quicker than standard sequential dilators.

1984 Biofeedback Self Regul 9;3:281-9

Barnes, J., Bowman, E. P., and Cullen, J.

6102843 JA

68/71 women with vaginismus were successfully treated with a very involved 1980s type of program of progressive hypnotic desensitization.

1980 Am J Obstet Gynecol 137;1:1-7

Fuchs, K.

Women with vulvar vestibulitis reported drastic decreases in sexuality and sexual activity with onset of symptoms, as well as high levels of frustration and symptoms of depression. Intimate relationships and psychological well-being need to be taken into account as well as physical concerns during treatment.

2001 J Reprod Med 46;6:593-8

Sackett, S., Gates, E., Heckman-Stone, C., Kobus, A. M., and Galask, R.

8892160 RCT

In this small Dutch study of vulvar vestibulitis syndrome, women treated with a behavioral approach did not have significantly different results than those who were operated on first. The behavioral approach consisted of an educative pelvic exam, pelvic floor muscle exercises, biofeedback, hygienic protocol, appropriate sex counseling, and appropriate couples counseling. Authors suggest this approach be tried with all of these patients initially.

1996 J Psychosom Obstet Gynaecol 17;3:143-8

Weijmar Schultz, W. C., Gianotten, W. L., van der Meijden, W. I., van de Wiel, H. B., Blindeman, L., Chadha, S., and Drogendijk, A. C.

11275387 RCT

Cognitive-behavioral therapy (including relaxation and imagery), biofeedback, and surgery all significantly reduced pain and improved psychological and sexual functioning in 78 vulvar vestibulitis patients.

2001 Pain 91;3:297-306

Bergeron, S., Binik, Y. M., Khalife, S., Pagidas, K., Glazer, H. I., Meana, M., and Amsel, R.

10912437 R,T

Review of studies on vulvar vestibulitis shows 89% complete or partial response to perineoplasty, and no difference than the normal population with respect to marital satisfaction, psychologic distress or psychopathology. History of childhood sexual abuse effect could not be confirmed.

1999 Obstet Gynecol 93;5 Pt 2:876-80

Bornstein, J., Zarfati, D., Goldik, Z., and Abramovici, H.

11589808 R,T

Medline review of this syndrome leads authors to no conclusion about etiology, diagnostic criteria, or treatment. Suggestions made about future research.

2001 Int J STD AIDS 12;11:705-9

Green, J., Christmas, P., Goldmeier, D., Byrne, M., and Kocsis, A.

Of a random survey of 480 Bostonian women, 18.5% reported a history of genital discomfort >3 months, consisting either of pain on contact or itching and burning. There was an increased association with these symptoms and having increased levels of pain with menses.

2001 Am J Obstet Gynecol 185;3:545-50

Harlow, B. L., Wise, L. A., and Stewart, E. G.

10782746 JA

In a random survey of 2000 American women, 6.5% reported at least one episode of presumed candida vaginitis during the previous two months; 37.2% of these women had experienced at least four episodes in the past year.

2000 Sex Transm Dis 27;4:230-5

Foxman, B., Barlow, R., D'Arcy, H., Gillespie, B., and Sobel, J. D.

11118561 R,T

In recent years there has been an increased incidence of women with recurrent vaginal candida problems, as well as non-albicans species of candida. In the balance between candidal organisms and vaginal defenses, vaginitis appears because of an increased number or an enhanced virulence of candida, vs. decreased vaginal defense mechanisms. Defenses consist of lactobacilli, local cellular and systemic immunity.

2000 Int J Gynaecol Obstet 71 Suppl 1;S21-7

Ferrer, J.

11361971 R,T

Studies have suggested that local immunity is more important than systemic circulation for protection against vulvovaginal candidiasis. Article reviews host defenses.

1998 AIDS Patient Care STDS 12;5:359-66

Fidel, P. L. Jr

10076122 JA

Heat shock protein is produced in response to stress. In women with a history of recurrent vulvovaginitis, who were not actively experiencing an infection, a significant amount of vaginal heat shock protein was detected (45.7%) vs. a control group who did not experience infections (5.3%) (p = .005).

1999 Am J Obstet Gynecol 180;3 Pt 1:524-9

Giraldo, P., Neuer, A., Korneeva, I. L., Ribeiro-Filho, A., Simoes, J. A., and Witkin, S. S.

9929843 JA

Lengthy discussion of a single case of vulvodynia successfully treated with extensive Freudian psychotherapy. The imagery of burning had sexual implications for this patient, and "under certain circumstances, the body expresses what the mind and words are unable to express."

1998 J Psychosom Obstet Gynaecol 19;4:175-81

Pucheu, S.

6630605 JA

Single case report of a women with drug treatment-resistant vulvar condylomata, totally cleared in four weekly sessions with hypnosis. Script given.

1983 J Am Acad Dermatol 9;3:434-6

Straatmeyer, A. J. and Rhodes, N. R.

Genital herpes affects over 30 million persons in the US (1993 data). Article discusses clinical presentation, diagnosis and treatment. Psychological concerns at first diagnosis need to be addressed tactfully. Questions patients need answered are: How did they get this? When did they get this? How many outbreaks will there be and how long will they last? In addition, information is needed on pain control, treatment options, potential infectiousness to partner and family, adjustments in sexual habits, effect on pregnancy, how to tell partner, and feelings of social isolation.

1995 Am Fam Physician 51;1:175-82, 187-8

Clark, J. L., Tatum, N. O., and Noble, S. L.

11385226 JA

More than half of the patients at a Swiss dermatology clinic who were diagnosed with herpes virus type 2 had atypical presentations--moreso in women. Genital herpes is significantly under-diagnosed.

2001 Dermatology 202;3:211-9

Lautenschlager, S. and Eichmann, A.

3480065 JA

During days 0-3 of a herpes recurrence, natural killer (NK) cells showed significantly reduced cytotoxicity, whereas NK activity was significantly increased during the convalescent phase (d 4-14), compared to controls.

1987 Cancer Detect Prev Suppl 1;51-5

Kuo, Y. C., Lin, C. Y., Cheng, S. F., Lin, C. C., and Liu, W. T.

2565589 JA

In this study of 36 patients with recurrent herpes, stressful life experiences significantly decreased percentages of CD4 and CD8 cells. Negative mood (anxiety, depression, or hostility) decreased CD8 cells only. Depression was the only parameter significantly associated with increased recurrence rates.

1989 Psychosom Med 51;2:195-208

Kemeny, M. E., Cohen, F., Zegans, L. S., and Conant, M. A.

9389946 JA

In a study of 116 British patients with recurrent herpes, coping style and personality characteristics were more predictive of recurrences than stress levels.

1997 Genitourin Med 73;4:263-6

Cassidy, L., Meadows, J., Catalan, J., and Barton, S.

9389944 R

Patients with recurrent herpes experience considerable stress from their disease, but most eventually adjust psychologically. Antiviral treatment can help with adjustment.

1997 Genitourin Med 73;4:253-8

Green, J. and Kocsis, A.

8244359 JA

Over time, most patients are able to adjust psychologically to having recurrent herpes. However, a subset may require counseling.

1993 Genitourin Med 69;5:384-7

Brookes, J. L., Haywood, S., and Green, J.

Increased anger about their herpes situation in both men and women was significantly predictive of depression.

2000 Public Health Nurs 17;3:187-94

Dibble, S. L. and Swanson, J. M.

7792371 JA

In this small Swedish study, recurrent genital herpes was associated with reduced and decreasing overall emotion well-being over a period of 10 days. This was more pronounced for women than for men, and was not attributable to the menstrual cycle. For men, decreased amount of sleep was strongly associated with recurrences the following week.

1995 Psychosom Med 57;2:127-37

Dalkvist, J., Wahlin, T. B., Bartsch, E., and Forsbeck, M.

3003360 JA

Medical students experienced a significant increase in herpes virus titers during exam stress. High loneliness subjects had even significantly higher titers.

1985 J Behav Med 8;3:249-60

Glaser, R., Kiecolt-Glaser, J. K., Speicher, C. E., and Holliday, J. E.

10469525 JA

West Point cadets did not demonstrate an increase in herpes virus titers after a rigorous cadet basic training course, or in the week prior to finals. However, there were significant increases during both periods in Epstein-Barr virus.

1999 Brain Behav Immun 13;3:240-51

Glaser, R., Friedman, S. B., Smyth, J., Ader, R., Bijur, P., Brunell, P., Cohen, N., Krilov, L. R., Lifrak, S. T., Stone, A., and Toffler, P.

10665891 JA

In this study of 58 women followed prospectively for six months, weekly increased persistent stress predicted an outbreak the following week, and highest monthly overall anxiety also predicted a recurrence. Transient mood states, short-term stress, and life change events were not related to outbreaks.

1999 Arch Intern Med 159;20:2430-6

Cohen, F., Kemeny, M. E., Kearney, K. A., Zegans, L. S., Neuhaus, J. M., and Conant, M. A.

Four subjects with a history of frequent recurrences of genital herpes were taught applied relaxation. They had a significant reduction in number of outbreaks, but minimal change in duration or severity, leading to the hypothesis that relaxation was more preventative than remedial.

1993 J Behav Ther Exp Psychiatry 24;4:331-41

Koehn, K. A., Burnette, M. M., and Stark, C.

3279091 RCT

In treatment of recurrent genital herpes, a psychosocial group (which included stress management, relaxation and an imagery tape) showed significant reductions in episode frequency, duration and severity as well as decreasing emotional distress and loneliness, compared to a control group and a general support group.

1988 J Consult Clin Psychol 56;1:61-6

Longo, D. J., Clum, G. A., and Yaeger, N. J.

Small series (4 patients) with high-frequency recurrences of genital herpes showed substantial reduction in frequency with either biofeedback or progressive muscle relaxation treatment.

1985 Biofeedback Self Regul 10;2:181-8

VanderPlate, C. and Kerrick, G.

10563560 JA

In a group of patients with recurrent herpes who responded to hypnotherapy, there was a significant reduction in recurrences, elevations of CD3, CD8, NK and LAK cells, and decreased anxiety. [For powerpoint slides of this article, see Mind-Body Connection]

1999 Int J STD AIDS 10;11:730-4

Fox, P. A., Henderson, D. C., Barton, S. E., Champion, A. J., Rollin, M. S., Catalan, J., McCormack, S. M., and Gruzelier, J.

6541430 JA

Case report of two patients who experienced decreased symptoms, decreased recurrences, decreased anxiety and elevated mood following use of hypnotic imagery. Detailed scripts included. "...allowing the patients to utilize their own healing imagery will personalize their treatment."

1984 Am J Clin Hypn 26;3:171-4

Gould, S. S. and Tissler, D. M.

3383831 JA

In this study of 16 patients with genital herpes, loneliness scores were associated with higher recurrence rates, and recurrences were preceded by elevated anxiety. Cognitive restructuring therapy was associated with reduced frequency of lesions.

1988 Health Psychol 7;3:231-49

McLarnon, L. D. and Kaloupek, D. G.