7th March 2022

Pain during sex can be treated – HelloBetter’s digital therapy “Vaginismus Plus” is available free of charge on prescription in Germany

Roughly one fifth of women experience pain during penetrative sex. Yet, there are hardly any therapeutic offers tailored to the needs of those affected, 20% of whom have been found to avoid sexual intimacy altogether.

  • The digital therapy programme HelloBetter Vaginismus Plus offers easy and quick access to effective psychotherapeutic help, tailored to the needs of people suffering from vaginismus (cramping of the vaginal muscles) or dyspareunia (pain caused by penetrative sex, or the insertion of menstrual products).
  • In a clinical study, HelloBetter Vaginismus Plus successfully reduced anxiety surrounding sex and intimacy and increased participants’ ability to engage in penetrative sex and non-sexual penetrative activities.
  • The first of its kind, this digital health app is now available free of charge on prescription for all adults with health insurance in Germany.


Berlin, 7th March 2022 – More than 20 percent of pre-menopausal women are affected by pain caused by penetration, and this jumps to 30 percent for postmenopausal women. Experts, however, believe many more to be suffering in silence, with prevalence rates ranging from 1 to 72 per cent, due to varying diagnostic criteria and stigma regarding sexual health. HelloBetter, a Berlin-based digital health company, has developed a digital therapy programme, with online support from psychologists and psychotherapists, that effectively reduces the occurrence of painful penetration. The effectiveness of HelloBetter Vaginismus Plus has been demonstrated in two clinical studies and this digital medical product is now available on prescription and free of charge across Germany.


Symptoms of Vaginismus and Dyspareunia

The digital therapy programme HelloBetter Vaginismus Plus is for those affected by pain during penetration (dyspareunia) or involuntary tightening of the pelvic floor muscles, which makes insertion of a penis, tampon or a gynaecological examination painful or impossible (vaginismus). In the Diagnostic and Statistical Manual of Mental Disorders (DSM–5), dyspareunia and vaginismus are combined under the umbrella term of genito-pelvic pain/penetration disorder (GPPPD). Both fear and negative feelings play a central role in such disorders. For a long time, there were hardly any effective therapeutic methods, which had undergone extensive clinical trials, and very few experts specialised in the treatment of pain during penetration, meaning that those affected very seldom received the practical and effective help they required.

“Research into effective therapeutic methods of managing sexual difficulties in women is still a fringe area, which does not receive enough attention globally. This is where HelloBetter Vaginismus Plus comes in because it offers sufferers effective support available anytime, anywhere. This online therapy programme closes a gap in care in the area of sexual health,” says e-Mental Health researcher, Dr Anna-Carlotta Zarski, from the Technical University of Munich and the Friedrich-Alexander University of Erlangen, who co-developed this digital intervention and conducted the studies validating its effectiveness.

“Not only does vaginismus cause physical pain, but it also puts an enormous strain on the psyche, especially when those affected have the feeling that something is wrong with their genitals, which as a rule generally leads to self-doubt, problems in relationships and despair. Shame often hinders treatment and even if those affected seek help, there are hardly any appropriately trained specialists, so that the suffering becomes chronic over time,” says the psychologist and co-founder of HelloBetter, Dr. Elena Heber.


How HelloBetter Vaginismus Plus can help

HelloBetter Vaginismus Plus provides immediate psychological help, specific to the needs of people who experience pain during penetration. This online therapy course is based on the well-established methods of Cognitive Behavioral Therapy (CBT). It consists of a twelve week course of treatment, comprising of eight modules, which should be completed every week, and a revision module. These can be completed flexibly and share knowledge about the symptoms of vaginismus, as well as support strategies for coping with the discomfort. Numerous exercises help users – alone or with their partner – to combat the fears and challenges associated with the topic step-by-step, and learn to insert a dilator. After each session, patients receive personalised written feedback from a HelloBetter psychologist. These coaches give feedback and support to patients experiencing difficulties. In order to apply their knowledge in everyday situations, users have access to a companion app that includes additional exercises and a feature allowing them to monitor their progress.

The therapy program also supports physicians treating such patients, who are often confronted with the problem that their patients are stuck in a vicious circle: the pain they have previously experienced causes anxiety, which, in turn, leads to further tension or cramping, which results in patients being unable to have positive sexual experiences and often avoiding sexual situations altogether. HelloBetter Vaginismus Plus succeeds in making it possible to break this circle and achieve a long-lasting improvement in symptoms.


Efficacy of HelloBetter Vaginismus Plus proven in two clinical trials

The effectiveness of HelloBetter Vaginismus Plus has been demonstrated in a clinical study, which has recently been published in a highly respected international journal¹. The product has been tested and approved by the German Federal Institute for Drugs and Medical Devices (BfArM). Products that meet the strict requirements of the BfArM are included in the DiGA (Digital Healthcare Solutions) directory, where doctors and psychotherapists can find out which products are suitable for their patients and then prescribe them. The costs for participation are covered by the statutory health insurance funds.

The latest clinical study for HelloBetter Vaginismus Plus was conducted under the direction of Dr. Anna-Carlotta Zarski and Prof. Dr. David Daniel Ebert from the Friedrich Alexander University Erlangen-Nuremberg and the Technical University of Munich. Compared to a control group, participants in a trial of HelloBetter Vaginismus Plus experienced a significant reduction in pain and anxiety before or when engaging in penetrative sex. Many participants had never been able to have sex without pain before taking part in the programme. After the programme, many participants reported that they were now able to do so. Satisfaction with the therapy was extremely high: 97.2 percent of participants would recommend HelloBetter Vaginismus Plus to others.

HelloBetter was founded in 2015 and offers digital therapy programmes for the prevention and treatment of mental illnesses. HelloBetter’s medical products have received many awards for their evidence-based and user-centred approach to therapy, and have also won many awards from Germany’s independent consumer watchdog (Stiftung Warentest). In the last two years, HelloBetter, a pioneer of e-mental health, has rapidly expanded and has been able to gain numerous health insurance companies as partners.

HelloBetter Vaginismus Plus is the fourth DiGA (Digital Healthcare Solutions) from HelloBetter and is available free of charge on prescription.


Further information



¹ Zarski, A. C., Berking, M., & Ebert, D. D. (2021). Efficacy of internet-based treatment for genito-pelvic pain/penetration disorder: results of a randomized controlled trial. Journal of consulting and clinical psychology, 89(11), 909.


About HelloBetter

HelloBetter is one of the world’s leading providers of digital medical products. The company was founded in 2015 by psychologists Prof. David Ebert, Dr. Hanne Horvath and Dr. Elena Heber. David Ebert, Professor of Psychology & Digital Mental Health Care at the Technical University of Munich, is an internationally renowned expert and a global pioneer in digital interventions for mental illness. HelloBetter offers ten therapy programmes from eight problem areas. Not only do these programmes serve to prevent and treat common mental illnesses, such as depression, anxiety or panic disorders, but they also cover topics, including vaginismus and chronic pain. Currently, the Federal Institute for Drugs and Medical Devices (BfArM) have approved four of HelloBetter’s therapeutic programmes, all of which are available free of charge on prescription for all adults with health insurance. No other company can boast more federally approved digital health applications. To date, more than 30 randomised-controlled studies on the efficacy and cost-effectiveness of the therapy programmes have been conducted and published in peer-reviewed journals. Worldwide no other digital healthcare provider can boast such a broad range of scientific support. HelloBetter is based in Berlin and Hamburg and employs more than 100 people. Further information is available at https://hellobetter.de/en/


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