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Romantic Partners’ Reponses to Entry Dyspareunia

Dyspareunia – painful intercourse for women – can be devastating for couples who want to have a happy intimate relationship.

Some causes of dyspareunia might be easier to pinpoint than others. Poor lubrication, certain medical conditions (such as ovarian cysts or pelvic inflammatory disease), allergies, and poorly-fitting birth control devices are examples.

Other times, the causes are more elusive. A woman’s body may be responding to emotional problems or trouble in the relationship. She might not be able to articulate that to her partner. She might have vaginismus - involuntary spasms of the pelvic muscles that can make intercourse impossible. But she might not know why these spasms occur and feel guilty about her inability to control them.

Dyspareunia can be difficult for male partners to understand, too. Men may feel frustrated, wondering why something that should be so natural has become so difficult. They may also feel depressed about the relationship, as if the woman is rejecting them. They could feel anxious about intercourse itself, knowing that they induce this pain. Some men are patient and supportive; others pull away from the relationship or become hostile.

Research has shown that partner response can affect pain intensity for women with dyspareunia. Today, we’ll look at a recent study published in the Journal of Sexual Medicine. In particular, this study looks at two types of men’s cognitions: catastrophizing and self-efficacy.

The Study

A Canadian research team collected data from 179 heterosexual couples who were dealing with entry dyspareunia, pain caused by vaginal penetration. The women’s mean age was 31 years; for men, it was 33. The couples had been together for a mean of six years. The women had been having pain for a mean of six years, too.

Using a variety of questionnaires, the researchers assessed the women’s pain intensity, sexual functioning, and sexual satisfaction.  They also measured levels of catastrophizing and self-efficacy for both men and women.

Catastrophizing was defined as “an exaggerated and negative set of cognitions during real or anticipated painful experiences.” Put another way, catastrophizing involves expectations of a negative outcome and the belief that that outcome would be a catastrophe. For example, a man may expect penetration to be difficult in one sexual encounter, then catastrophize, believing that the couple will never have vaginal intercourse.

Self-efficacy was defined as “the confidence an individual has in his or her ability to perform a specific task.” In this study, researchers focused on the way a male partner perceived his female partner’s self-efficacy. A man with a high level of partner-perceived self-efficacy would believe that his partner had confidence that she could have painless intercourse.

After controlling for the women’s catastrophizing and self-efficacy, the researchers found that women’s pain was less intense when their partners catastrophized less and had higher levels of partner-perceived self-efficacy. In other words, pain was less severe when the men did not expect a catastrophic outcome and highly believed in his partner’s confidence about intercourse.

Why did this happen? The researchers suggested that the men’s cognitions might have made the women more aware of their pain. Heightened awareness could have made the pain more intense.

Implications for Practice

The study results give us a lot to think about as healthcare providers. Having a man consider his reactions to his partner’s pain – and how that reaction might affect the intensity of her pain – is one starting point. It may help for him to think about her point of view.

Clinicians can also benefit from viewing dyspareunia as the couple’s problem, not just the woman’s. While it’s the woman that feels the pain, both partners feel the tension and frustration. Couple-oriented therapies can help both partners learn to communicate about what’s happening and keep their relationship strong as they struggle to overcome painful sex.

Resources

The Journal of Sexual Medicine

Lemieux, Ashley J., MA, et al.

“Do Romantic Partners' Responses to Entry Dyspareunia Affect Women's Experience of Pain? The Roles of Catastrophizing and Self-Efficacy”

(Full-text. First published online: June 27, 2013)

http://onlinelibrary.wiley.com/doi/10.1111/jsm.12252/abstract

PsychCentral

Grohol, John M., PsyD

“What is Catastrophizing?”

(Last reviewed: January 30, 2013)

http://psychcentral.com/lib/what-is-catastrophizing/0001276

Sexual Medicine Society of North America

“Pain During Sex – Vaginismus”

http://www.sexhealthmatters.org/did-you-know/pain-during-sex-vaginismus

“Painful Intercourse for Women”

http://www.sexhealthmatters.org/did-you-know/painful-intercourse-for-women