East Toronto Therapy

Research on Provoked Vestibulodynia

I recently had the pleasure of attending the annual conference for the Society for Sex Therapy and Research (SSTAR). This conference presents research and clinical practice updates on a variety of sexuality topics, including erectile dysfunction, low desire, and the impact of trauma on sexual relationships. There were a number of presentations about new research on female pelvic pain. One example of this was the presentation by Rosen et al. on the sex lives of heterosexual couples in which the female partner has provoked vestibulodynia.

Provoked vestibulodynia (also referred to as vulvar vestibulitis and vulvodynia) is a form of pelvic pain in which a woman experiences pain in the vulvar vestibule (the external genitals at the entrance to the vagina) when the area is touched. This pain can occur with any type of touch, including tampon insertion, gynecological exam, sexual intercourse, and in some cases pressure on the vulva from sitting. To see my earlier post on vulvodynia, When Sex Hurts, click here.

Despite experiencing pain with sexual intercourse, Rosen et al. reported that over 80% of women with provoked vestibulodynia engage in sexual intercourse regularly. Their reasons for doing so are primarily interpersonal, such as to pursue a positive outcome including feeling closer and maintaining the relationship. In their study, Rosen et al. found that women with provoked vestibulodynia who continued to engage in sexual activity had higher sexual satisfaction and relationship satisfaction, while those who avoided sex had higher rates of depression, lower sexual satisfaction, and lower relationship satisfaction. Of course, it is possible that these negative characteristics lead to less sex, as opposed to less sex leading to the negative characteristics of depression and lower sexual and relationship satisfaction. However, the authors suggest that women who avoid sex may end up increasing their fears, as they do not have the opportunity to experience positive sexual encounters.

I was so pleased to see this research devoted to an under-studied concern that affects many women. As a sex therapist that works with women experiencing pain during intercourse from provoked vestibulodynia and other causes, I address the impact of pelvic pain on the woman and on the relationship. I help women get back in touch with the pleasurable aspects of sex, reduce the distress associated with pain conditions, and regain desire. So often for women with pain during intercourse, sex becomes a big deal: something that is clouded by feelings of anxiety, fear, and guilt. In such a pressure-filled environment, it can be almost impossible to enjoy any type of sexual activity. Sex therapy can help you (and your partner) regain a pleasurable sex life.