Isabelle Delisle

Impact of male partner responses on sexual function in women with vulvodynia and their partners: a dyadic daily experience study.

OBJECTIVE There is a paucity of research investigating the role of interpersonal variables in vulvodynia--a prevalent, chronic, vulvo-vaginal pain condition that negatively affects many aspects of womens sexual health, emotional well-being and intimate relationships. Cross-sectional studies have shown that male partner responses to painful intercourse are associated with pain and sexual satisfaction in women with vulvodynia. Partner responses can be solicitous (attention and sympathy), negative (hostility and frustration), and facilitative (encouragement of adaptive coping). No research has assessed the influence of daily partner responses in this population. Further, there is limited knowledge regarding the impact of partner responses on sexual function, which is a key measure of impairment in vulvodynia. METHODS Using daily diaries, 66 women (M age = 27.91, SD = 5.94) diagnosed with vulvodynia and their cohabiting male partners (M age = 30.00, SD = 8.33) reported on male partner responses and sexual function on days when sexual intercourse occurred (M = 6.54, SD = 4.99). Drawing on the Actor-Partner Interdependence model (APIM), a multivariate multilevel modeling approach was adopted. RESULTS A womans sexual functioning improved on days when she perceived greater facilitative and lower solicitous and negative male partner responses, and when her male partner reported lower solicitous responses. A mans sexual functioning was poorer on days when he reported greater solicitous and negative responses. CONCLUSIONS Findings suggest that facilitative male partner responses may improve sexual functioning whereas solicitous and negative responses may be detrimental. Partner responses should be targeted in psychological interventions aimed to improve the sexual functioning of affected couples.

Relationship satisfaction moderates the associations between male partner responses and depression in women with vulvodynia : a dyadic daily experience study.

Summary Targeting male partner responses and relationship satisfaction may enhance the quality of interventions aimed at reducing depression in women with vulvodynia. ABSTRACT Vulvodynia is a prevalent vulvovaginal pain condition that interferes with womens psychological health. Given the central role of sexuality and relationships in vulvodynia, relationship satisfaction may be an important moderator of daily partner responses to this pain and associated negative sequelae, such as depression. Sixty‐nine women (M age = 28.12 years, SD = 6.68) with vulvodynia and their cohabiting partners (M age = 29.67 years, SD = 8.10) reported their daily relationship satisfaction, and male partner responses on sexual intercourse days (M = 3.74, SD = 2.47) over 8 weeks. Women also reported their depressive symptoms. Relationship satisfaction on the preceding day moderated the associations between partner responses and womens depressive symptoms in several significant ways: (1) On days after women reported higher relationship satisfaction than usual, their perception of greater facilitative male partner responses was associated with their decreased depression; (2) on days after women reported lower relationship satisfaction than usual, their perception of greater negative male partner responses was associated with their increased depression; (3) on days after men reported higher relationship satisfaction than usual, their self‐reported higher negative responses were associated with decreased womens depression, and higher solicitous responses were associated with increased womens depression, whereas (4) on days after men reported lower relationship satisfaction than usual, their self‐reported higher negative responses were related to increased womens depression, and higher solicitous responses were associated with decreased womens depression. Targeting partner responses and relationship satisfaction may enhance the quality of interventions aimed at reducing depression in women with vulvodynia.

Daily Associations Between Partner Responses and Sexual and Relationship Satisfaction in Couples Coping with Provoked Vestibulodynia

INTRODUCTION Women with provoked vestibulodynia (PVD) experience a recurrent vulvo-vaginal pain triggered primarily during sexual intercourse. Although affected couples report adverse effects on their sexual and global romantic relationships, few studies have examined interpersonal factors that may influence their sexual and relationship satisfaction. Cross-sectional studies have shown that greater partner solicitous and negative responses and lower facilitative responses are associated with poorer sexual and relationship satisfaction in women with PVD. AIM The aim of this study was to investigate the within-person associations between partner responses to painful intercourse and the sexual and relationship satisfaction of affected couples. METHODS In a dyadic daily experience study, 69 women (M(age) = 28.46, SD = 6.66) diagnosed with PVD and their cohabitating male partners (M(age) = 30.29, SD = 8.13) reported on male partner responses, as well as sexual and relationship satisfaction on sexual intercourse days (M = 6.81; SD = 5.40) over 8 weeks. MAIN OUTCOME MEASURES Dependent measures were the (i) Kansas Marital Satisfaction Scale and (ii) Global Measure of Sexual Satisfaction Scale. RESULTS On sexual intercourse days when women perceived more facilitative partner responses than usual and on days when they perceived lower negative partner responses than usual, they reported higher sexual and relationship satisfaction. On sexual intercourse days when men reported more solicitous responses than usual, both they and their female partners reported lower sexual satisfaction. CONCLUSIONS Interventions aimed at improving the day-to-day sexual and relationship satisfaction of couples with PVD should target increasing facilitative and decreasing negative and solicitous partner responses.

A comparison of cognitive-behavioral couple therapy and lidocaine in the treatment of provoked vestibulodynia: study protocol for a randomized clinical trial

BackgroundProvoked vestibulodynia (PVD), a frequent form of chronic genital pain, is associated with decreased sexual function for afflicted women, as well as impoverished sexual satisfaction for women and their partners. Pain and sexuality outcomes for couples with PVD are influenced by interpersonal factors, such as pain catastrophizing, partner responses to pain, ambivalence over emotional expression, attachment style and perceived relationship and sexual intimacy. Despite recommendations in the literature to include the partner in cognitive-behavioral therapy targeted at improving pain and sexuality outcomes, no randomized clinical trial has tested the efficacy of this type of intervention and compared it to a first-line medical intervention.MethodsThis bi-center, randomized clinical trial is designed to examine the efficacy of cognitive-behavioral couple therapy compared to topical lidocaine. It is conducted across two Canadian university-hospital centers. Eligible women diagnosed with PVD and their partners are randomized to one of the two interventions. Evaluations are conducted using structured interviews and validated self-report measures at three time points: Pre-treatment (T1: prior to randomization), post-treatment (T2), and 6-month follow-up (T3). The primary outcome is the change in reported pain during intercourse between T1 and T2. Secondary outcomes focus on whether there are significant differences between the two treatments at T2 and T3 on (a) the multidimensional aspects of women’s pain and (b) women and partners’ sexuality (sexual function and satisfaction), psychological adjustment (anxiety, depression, catastrophizing, self-efficacy, and quality of life), relationship factors (partner responses and dyadic adjustment) and self-reported improvement and treatment satisfaction. In order to detect an effect size as small as 0.32 for secondary outcomes, a sample of 170 couples is being recruited (27% dropout expected). A clinically significant decrease in pain is defined as a 30% reduction.DiscussionThe randomized clinical trial design is the most appropriate to examine the efficacy of cognitive-behavioral couple therapy, a recently developed and pilot-tested psychosocial intervention for couples coping with PVD, in comparison to a frequent first-line treatment option, topical lidocaine. Findings from this study will provide important information about empirically supported treatment options for PVD, and inform future treatment development and research for this patient population.Trial registrationClinicaltrials.gov NCT01935063; registration date: 27 August 27 2013.

Sexual Distress Mediates the Associations Between Sexual Contingent Self-Worth and Well-Being in Women With Genitopelvic Pain: A Dyadic Daily Experience Study

Provoked vestibulodynia (PVD), a common cause of women’s genitopelvic pain, is associated with poorer psychological and sexual well-being in affected couples. Greater sexual contingent self-worth (CSW)—defined as self-esteem that is dependent on the perceived success or failure of a sexual relationship—has been linked to poorer well-being in a cross-sectional study of couples coping with PVD. This study aimed to examine whether daily sexual distress mediated the associations between greater sexual CSW and lower sexual satisfaction and greater anxiety, depressed mood, and women’s pain in affected couples. Women (N = 125) diagnosed with PVD and their partners completed the Sexual CSW Scale and then online daily surveys for eight weeks measuring sexual distress, sexual satisfaction, anxiety, depressed mood, and women’s pain during intercourse. Multilevel analyses were based on the actor–partner interdependence model (APIM). For women who had higher sexual CSW (compared to lower sexual CSW), on sexual activity days when their sexual distress was higher, they reported lower sexual satisfaction and greater anxiety, depressed mood, and pain (compared to their average level across all sexual activity days). Findings suggest that daily sexual distress may be one pathway between greater sexual CSW and poorer day-to-day well-being in women with PVD.