Partner response to a woman’s provoked vestibulodynia appears to play a role in the intensity of her pain and sexual satisfaction, according to Canadian researchers.
Solicitous responses are associated with higher degrees of pain, whereas facilitative responses are associated with decreased pain and higher sexual satisfaction.
The results were first published online in the July 19, 2012 edition of the Journal of Sexual Medicine.
Provoked vestibulodynia, or PVD, is a subtype of vulvodynia, chronic pain in the vulvar region caused by unknown factors. Women with PVD have pain in the vestibule area, which surrounds the opening to the vagina. Any pressure on the area – including sexual intercourse – can cause pain.
PVD can lead to diminished libido, fewer orgasms, and less frequent intercourse, along with depression and anxiety. Men often have less sexual satisfaction when their partner has PVD.
One hundred twenty-one women with a median age of 31 participated in the study. The women completed questionnaires about their partners’ responses to PVD as well as their levels of pain, sexual function, sexual satisfaction, trait anxiety, and avoidance of pain and sexual activity.
Solicitous responses were described as sympathetic and supportive. Solicitous male partners might ask if there is anything they can do to help or suggest that the couple not have sex because of the woman’s pain.
Facilitative responses were described as adaptive. Facilitative partners would encourage the woman with PVD to cope with the pain. They might also tell the woman they were glad she is still having sex.
The researchers found that after controlling for trait anxiety and avoidance, women tended to have more intense pain when their partners were more solicitous. When partners were more facilitative, women tended to have less intense pain. Also, after controlling for sexual function, trait anxiety and avoidance, women had higher rates of sexual satisfaction when their partners were more facilitative.
The authors noted that solicitous responses may make women more likely to avoid sex and, therefore, increase pain. “In the context of PVD,” they wrote, “partner solicitous responses may increase pain by encouraging avoidance of penetrative as well as nonpenetrative sexual activities; the latter is possibly a result of women’s fear that nonpenetrative activities will still lead to painful intercourse.”
In addition to increased physical pain, avoidance may lead to relationship and communication problems for the couple. Facilitative responses, on the other hand, may decrease pain intensity because they are encouraging and adaptive. The authors wrote, “Promoting adaptive coping may in turn generate positive cognitions that the pain is controllable, tolerable, and that sexual activities can still be pleasurable, leading to reduced pain.” Pain may be decreased when couples focus on pleasurable sexual activities that foster intimacy rather than the stress of painful intercourse.
The authors suggested that these findings may help clinicians who treat couples dealing with PVD. Partners may learn what kinds of responses may lessen pain.
The Journal of Sexual Medicine
Rosen, Natalie O., PhD, et al.
“Helpful or Harmful: Perceived Solicitous and Facilitative Partner Responses Are Differentially Associated with Pain and Sexual Satisfaction in Women with Provoked Vestibulodynia”
(Full text. First published online: July 19, 2012)
The American College of Obstetricians and Gynecologists
“Frequently Asked Questions – FAQ 127 – Gynecologic Problems – Vulvodynia”
National Vulvodynia Association
“What is Vulvodynia?”
(Last updated: February 2, 2012)