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Sexual Studies: Harmful or Helpful? How a Partner’s Response affects Pelvic Pain and Sexual Satisfaction

December 08, 2012

Every Saturday The CSPH highlights news or recent research in the field of human sexuality. This week we’re looking to see whether a partner’s response to provoked vestibulodynia (PVD) is harmful or helpful to women’s experience of pain and sexual satisfaction.  PVD is the most common type of localized pelvic pain, affecting 12% of the population, and is triggered by touching the vestibule.  The pain is chronic and associated with a variety of sexual side effects including, but not limited to, decreased arousal and heightened anxiety.

Research shows that how a woman’s partner responds to her pain plays a role in increasing or decreasing it.  On one hand, a solicitous response—when a partner expresses sympathy, anxiety, or concern—may prolong the pain by reinforcing avoidance of the painful activity (in this case sex), encouraging catastrophizing, and increasing the attention she pays to the pain.  However, on the other hand, a facilitative response—such as expressing happiness that one’s partner is engaging in sexual activity—may reduce pain by decreasing negative thoughts, distressing emotions, and one’s avoidance of painful activities. The goal of the current study was to determine if the latter response was associated with “better outcomes both for [PVD pain intensity] and sexual satisfaction.”  Such research was desperately needed and the results provide new ways for healthcare providers to address and treat PVD and other pelvic pain.

The researchers in this study surveyed over 100 college-educated, middle class women in their 20s through 40s residing in two Canadian cities.  All the women had been experiencing pain for at least the last six months and all were in stable, heterosexual relationships lasting at least as long.  A number of questionnaires were given to measure everything from their partners’ response to the women’s levels of anxiety, avoidance, and sexual functioning.  Participants from city two reported higher levels of both anxiety and the amount of facilitative partner response experienced.  Otherwise, the two groups did not differ significantly.  The similarity of these samples makes the study difficult to generalize, and the authors recognize this as a study limitation.  That being said, all new hypotheses need to start testing somewhere, and this relatively large first study provides a great jumping-off point for further research.

The results provide evidence for a link between higher facilitative partner response and decreased PVD pain, pain intensity, and avoidance of sexual activity.  While this is not surprising given that such a link already exists in the literature for other types of chronic pain, it is an important conclusion because it adds to the PVD literature and provides clinicians and therapists a new strategy to use with their patients and patients’ partners.  Furthermore, since the authors tell us that women view both types of responses as being supportive, it will be more important than ever to involve one’s partner in treatment for PVD.  In short, the study provides clinicians with new ways to discuss and treat patients suffering from PVD.

In even better news, the study shows that a facilitative response is also associated with greater sexual satisfaction. This provides one more reason to use the information from this study, as well as one more reason for its necessity.  For those experiencing PVD or who are in a relationship with someone experiencing PVD, this video series is a great “how to” for providing a facilitative response.  Finally, although the researchers found no relationship between a solicitous response and sexual satisfaction, the aforementioned pros and cons of each response type make it clear which is more favorable to both suffers of PVD and their partners.

Rosen NO, Bergeron S, Glowacka M, Delisle I, and Baxter ML. Harmful or helpful: Perceived solicitous and facilitative partner responses are differentially associated with pain and sexual satisfaction in women with provoked vestibulodynia. J Sex Med 2012;9:2351–2360.

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