Psychosexual aspects of vulvar vestibulitis

Department of Obstetrics and Gynecology, University of Iowa Health Care, Iowa City, USA.
The Journal of reproductive medicine (Impact Factor: 0.7). 07/2001; 46(6):593-8.
Source: PubMed


To explore the psychological, interpersonal and sexual correlates of vulvar vestibulitis via qualitative and quantitative analysis.
Sixty-nine women diagnosed with vestibulitis were recruited from a vulvar/vaginal disease clinic to complete a comprehensive quantitative and qualitative questionnaire designed to assess general health concerns, mental health, sexual functioning and interpersonal relationships.
The majority of participants reported drastic changes in sexuality associated with the onset of vestibulitis. Upon developing vestibulitis, 88% reported decreased interest in sexual activity, 87% indicated that they were less willing to participate in sexual activity, and 94% maintained that they were less able to participate in sexual activity. High levels of frustration and symptoms of depression also were frequently reported.
Vulvar vestibulitis is associated with significant changes in sexuality, intimate relationships and psychological well-being. When treating women with vestibulitis, medical professionals should consider the psychological and sexual aspects of the disease in addition to physical concerns.

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    • "As such, the Nylanderlundqvist & Bergdahl study was considered non-controlled for the purposes of this review. Of the four studies included in this section, one assessed the impact of PVD on the relationship (Nylanderlundqvist & Bergdahl, 2003), one assessed both sexual satisfaction and the impact of PVD on the relationship (Sackett et al., 2001), and two explored PVD-affected women's experiences using qualitative methodology. None of the studies utilized validated questionnaires for these purposes. "
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    ABSTRACT: The main objective of this article was to conduct a systematic review of the literature examining relationship adjustment and sexual satisfaction among women with provoked vestibulodynia (PVD). Although only a small number of studies have included partners, the literature regarding partner's relationship adjustment and sexual satisfaction was also examined. Relevant articles were identified by a literature search conducted between August 2008 and May 2010. Studies were included if they contained at least one group or subset of participants with PVD or dyspareunia (i.e., painful sexual intercourse), and if they assessed relationship adjustment or sexual satisfaction as a primary outcome measure. Within this review, the methodological quality of 33 studies was systematically rated, and effect sizes were calculated when possible. Methodological type and quality greatly varied across the studies, as did the pain samples included and the outcomes reported. Nevertheless, the results of controlled studies indicate that PVD is associated with decreased sexual satisfaction. The controlled results also suggest, however, that PVD is not necessarily associated with general relationship maladjustment for women and their partners. Future research, using various methodologies, is needed to further understand intimate relationships among women with PVD and the impact that this condition may have on couples.
    The Journal of Sex Research 03/2011; 48(2-3):166-91. DOI:10.1080/00224499.2011.555016 · 2.70 Impact Factor
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    • "We suggest that the lack of self-efficacy in sexual communication may help to explain the finding that there were very few differences in sexual behaviors between women with and without PVD. Although this link was not specifically examined in the current study, Sackett et al. (2001) found that women with PVD reported feeling guilty or inadequate as a sexual partner. Although the current study found no differences between women with PVD and control women in terms of their reported self-efficacy in refusal of sex and ability to cope with a partner's refusal, women with PVD may still feel guilty or lack confidence to discuss pain-free alternatives to penile-vaginal intercourse. "
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    ABSTRACT: Psychosocial and psychophysical functioning in 25 women with and 25 without provoked vestibulodynia (PVD) were examined. Participants underwent quantitative sensory testing and completed psychosocial measures. Women with PVD displayed lower pain thresholds, higher pain ratings, lower sexual functioning and sexual self-efficacy, and higher levels of somatization and catastrophization than controls. Lower psychosocial functioning correlated with decreased vulvar pressure-pain threshold and increased cotton-swab test pain ratings. For PVD women, decreased sexual function and sexual self-efficacy were associated with higher vulvar pressure-pain ratings. Findings suggest that women with PVD would benefit from treatment that addresses pain-focused and psychosocial components.
    Journal of Sex and Marital Therapy 02/2009; 35(4):262-81. DOI:10.1080/00926230902851256 · 1.27 Impact Factor
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    • "Psychosocial etiological pathways, such as personality characteristics, psychopathology, history of sexual abuse, and sexual and relationship adjustment have also been suggested; however, the correlational and cross-sectional nature of this research has resulted in debate as to whether these are causal factors or consequences of vulvodynia (Gates, 2000; Jantos & White, 1997; Masheb, Brondolo, & Kerns, 2002; Meana, Binik, Khalife, & Cohen, 1998; Reed et al., 2000; Wojnarowska, Mayor, Simkin, & Day, 1997). Current research into the psychosocial effects of living with vulvodynia suggests many women suffer psychological distress, with reports of high rates of depression, anxiety, and decreased sexual satisfaction (Gates, 2000; Jantos & White, 1997; Masheb et al., 2002; Meana, Binik, Khalife, & Cohen, 1997a; Sackett, Gates, Heckman-Stone, Kobus, & Galask, 2001; Stewart, Reicher, Gerulath, & Boydell, 1994; Wojnarowska et al., 1997), lower levels of relationship adjustment (Meana et al., 1997a; Sackett et al., 2001), physical and emotional limitations (Masheb et al., 2002; Sackett et al., 2001), and decrements in self-esteem (Katz, 1996). A number of researchers and clinicians have called for vulvodynia to be reclassified as a chronic pain syndrome in an attempt to move beyond the current bio-physiological emphasis (Bergeron, Binik, Khalife, & Pagidas, 1997; Binik, Meana, Berkley, & Khalife, 1999; Meana, Binik, Khalife, & Cohen, 1997b; Pukall, Payne, Binik, & Khalife, 2003; Turk & Okifuji, 2002). "
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    ABSTRACT: Vulvodynia has recently been recognized as a significant health problem among women, with a considerable proportion experiencing psychological distress and sexual dysfunction for many years. This study used a material-discursive framework and a qualitative methodology to investigate women's subjective experience of vulvodynia within the context of a hetero-sexual relationship, and their negotiation of coitus, commonly associated with vulvar pain. Seven women, who had experienced vulvodynia between 2 and 10 years, took part in in-depth interviews. Thematic decomposition drawing on a Foucauldian framework for interpretation identified that six of the seven women took up subject positions of "inadequate woman" and "inadequate partner," positioning themselves as failures for experiencing pain during coitus, which they interpreted as affecting their ability to satisfy their partners sexually, resulting in feelings of shame, guilt, and a decreased desire for sexual contact. This was interpreted in relation to dominant discourses of femininity and hetero-sexuality, which conflate a woman's sexuality with her need to be romantically attached to a man, position men as having a driven need for sex, and uphold coitus as the organizing feature of hetero-sex. Only one woman positioned herself as an "adequate woman/partner," associated with having renegotiated the coital imperative and the male sex drive discourse within her relationship. These positions, along with women's agentic attempts to resist them, were discussed in relation to their impact on hetero-sexual women's negotiation of vulvodynia. Implications for future research and vulvodynia treatment regimes are also raised.
    Archives of Sexual Behavior 05/2008; 37(2):294-304. DOI:10.1007/s10508-007-9204-1 · 3.53 Impact Factor
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