Types of sexual goals could be an important factor for the sexual well-being of couples coping with provoked vestibulodynia (PVD), according to new research by Canadian scientists.
Recognizing and understanding these goals may help clinicians who treat such couples, too.
Women with PVD experience pain in the vulvar vestibule area, generally where the vagina and the vulva meet. The pain can occur in sexual situations, like intercourse, and nonsexual situations, such as a routine pelvic exam with a gynecologist. An estimated 7% to 12% of premenopausal women are thought to have PVD.
Depression, anxiety, and sexual problems are common in women with PVD. They may feel guilty about the pain and inadequate as a sexual partner. Many worry that their partners will leave the relationship because of it. Partners may also be distressed.
Despite the pain, about 80% of women with PVD still have regular penetrative sex. The researchers wanted to know how sexual goals might affect the couples.
They classified two types of goals. Approach goals focus on positive outcomes, such as intimacy and pleasure.
In contrast, avoidance goals focus on avoiding negative outcomes, like an argument or the end of a relationship.
The researchers worked with 107 couples in Canada. One couple was in a same-sex relationship; the rest were heterosexual. The women were premenopausal, with a mean age of 28 years. Their partners’ mean age was 30 years. All of the couples had been in committed relationship for at least six months.
Each participant completed a number of questionnaires designed to assess approach and avoidance sexual goals, sexual and relationship satisfaction, and depression. Women with PVD also answered questions about pain during intercourse and sexual function.
The researchers found that higher avoidance goals in women with PVD were associated with lower sexual and relationship satisfaction and slightly lower sexual functioning. These women were also more likely to be depressed.
However, when women with PVD had higher approach goals, they tended to be more satisfied with their sex lives and their relationships. Their partners were “marginally” more satisfied as well.
Neither type of goal affected the women’s levels of pain. Other factors, including age, household income, and length of relationship, had no correlation either.
It’s possible that higher approach goals promote greater intimacy for couples, who can make adjustments to their sexual repertoire and include activities that are not painful. This can lead to greater satisfaction for both partners.
On the other hand, women with higher avoidance goals may feel less intimacy because they are so focused on avoiding negative outcomes. Associated depression and anxiety can take a physical toll as well, contributing to poor pelvic floor function and less arousal.
“Women who report greater avoidance goals may be primed to attend to negative cognitions and emotions associated with sexual activity rather than erotic ones,” the authors wrote.
The study was first published online in July in The Journal of Sexual Medicine.
Resources
The Journal of Sexual Medicine
Rosen, Natalie O., PhD
“Approach and Avoidance Sexual Goals in Couples with Provoked Vestibulodynia: Associations with Sexual, Relational, and Psychological Well-Being”
(Full-text. First published online: July 14, 2015)
http://onlinelibrary.wiley.com/doi/10.1111/jsm.12948/full