Psychological costs and benefits of sexual motivation in couples dealing with vulvodynia

Understanding the psychological underpinnings of sexual motivation can be helpful in improving the sexual and relationship well-being of couples affected by vulvodynia, according to recent research published inHealth Psychology.

Vulvodynia, which affects about 8% of reproductive-age women, is known to have an adverse impact on sexual relationships. It has also been observed that women with vulvodynia often engage in sexual intercourse in an effort to please their partners despite experiencing pain. These investigators evaluated the costs and benefits of the motivations behind this practice in an effort to improve sexual and relationship well-being.

Muse et al enrolled 95 women from two Canadian cities who had been diagnosed with vulvodynia, and their partners, in an 8-week study in which they were asked to characterize their sexual activity in terms of sexual function and sexual and relationship satisfaction. Women and their partners were also asked about sexual communal strength-defined as the extent to which people are motivated to be responsive without contingencies to their partners’ needs-which has been associated with enhanced sexual desire and more satisfaction with sex and a relationship. In addition, they were questioned about sexual unmitigated communion-defined as the act of placing partners’ needs over their own needs and worrying about and focusing on their partners to their own detriment-which has been associated with more distress, poor health behaviors, and less well-being.

Inclusion criteria were four-fold and included pain during intercourse that was distressing and had occurred frequently for ≥ 6 months, pain limited to pressure to the vestibule, pain during gynecologic exams, and sexual activity at least four times a week for at least 3 months. Patients with active infections, those who were pregnant or menopausal, and women who were aged ≤ 18 or ≥ 45 were excluded.

All of the subjects were interviewed over the phone and received a gynecologic exam at baseline. They were asked to keep daily diaries chronicling their sexual activity. Eighty-nine percent of diary entries were completed, and subjects reported a mean of 8.62 sexual activity days.   

Using validated tools to measure sexual communal strength and unmitigated sexual communion, the researchers found, as anticipated, that:

• When female subjects reported higher sexual communion strength, both they and their partners also reported greater sexual function and satisfaction. Their partners also had higher relationship satisfaction on these occasions.
• When the subjects’ partners reported higher sexual communion strength, both the women and the partners had higher sexual function. Partners reported greater sexual satisfaction and women reported more relationship satisfaction.
• When female subjects reported higher unmitigated sexual communion, they had worse sexual function and sexual satisfaction, and both the women and their partners had less relationship satisfaction.
• When the partners reported higher unmitigated sexual communion, they had poorer sexual function.

Relevance of findings

The role of interpersonal factors in chronic pain syndromes is increasingly being recognized, and this study contributes to that body of research. “Our findings revealed that although being motivated to meet a partner’s sexual needs can be beneficial for the sex lives and relationships of couples with vulvodynia, if this motivation is taken too far and a partner’s sexual needs are focused on to the exclusion of one’s own needs, then there may be negative sexual and relationship repercussions,” the authors wrote. They also noted that therapies such as cognitive behavioral therapy and acceptance-based strategies could be helpful in building sexual communal strength.