Skip to main content

Advertisement

SpringerLink
Log in

Female Sexual Pain Disorders: a Review of the Literature on Etiology and Treatment

  • Male Sexual Dysfunction and Disorders (SE Althof and AW Pastuszak, Section Editors)
  • Published:
Current Sexual Health Reports Aims and scope Submit manuscript

Abstract

Female sexual pain disorders, although highly prevalent and increasingly studied, remain a distressing complaint for women and their partners. Empirical evidence points to a multifactorial conceptualization of the etiology, course, and associated difficulties of sexual pain; thus, treatment options span the medical, pelvic floor rehabilitation psychological and multimodal. Given the interpersonal context in which sexual pain occurs, recent work has underscored the importance of considering the dyadic framework in research and treatment. This review presents understanding from across disciplines focusing on the impact of sexual pain on the woman and the couple, proposed etiologic pathways and risk factors related to its development and course, and current treatment options. Recommendations for research point to an urgency for multidisciplinary exchanges in the development of conceptual models and refinement of targeted interventions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Harlow BL, Kunitz CG, Nguyen RH, Rydell SA, Turner RM, MacLehose RF. Prevalence of symptoms consistent with a diagnosis of vulvodynia: population-based estimates from 2 geographic regions. Am J Obstet Gynecol. 2014;210(1):40.e1–8. doi:10.1016/j.ajog.2013.09.033. Important study about the prevalence of vulvodynia in women aged 18-40.

    Google Scholar 

  2. AmericanPsychiatricAssociation. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Publishing; 2013.

    Google Scholar 

  3. van Lankveld JJ, Granot M, Weijmar Schultz WC, Binik YM, Wesselmann U, Pukall CF, et al. Women’s sexual pain disorders. J Sex Med. 2010;7(1 Pt 2):615–31. doi:10.1111/j.1743-6109.2009.01631.x.

    PubMed  Google Scholar 

  4. Moyal-Barracco M, Lynch PJ. 2003 ISSVD terminology and classification of vulvodynia: a historical perspective. J Reprod Med. 2004;49(10):772–7. The official classification of vulvodynia and its subtypes.

    PubMed  Google Scholar 

  5. Bergeron S, Rosen NO, Morin M. Genital pain in women: beyond interference with intercourse. Pain. 2011;152(6):1223–5. doi:10.1016/j.pain.2011.01.035.

    PubMed  Google Scholar 

  6. Vlaeyen JW, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain. 2000;85(3):317–32. doi:10.1016/S0304-3959(99)00242-0.

    CAS  PubMed  Google Scholar 

  7. Lundqvist EN, Bergdahl J. Vulvar vestibulitis: evidence of depression and state anxiety in patients and partners. Acta Derm Venereol. 2003;83:369–73.

    Google Scholar 

  8. Granot M, Lavee Y. Psychological factors associated with perception of experimental pain in vulvar vestibulitis syndrome. J Sex Marital Ther. 2005;31(4):285–302. doi:10.1080/00926230590950208.

    PubMed  Google Scholar 

  9. Masheb RM, Wang E, Lozano C, Kerns RD. Prevalence and correlates of depression in treatment-seeking women with vulvodynia. J Obstet Gynaecol J Inst Obstet Gynaecol. 2005;25(8):786–91. doi:10.1080/01443610500328199.

    CAS  Google Scholar 

  10. Desrochers G, Bergeron S, Landry T, Jodoin M. Do psychosexual factors play a role in the etiology of provoked vestibulodynia? A critical review. J Sex Marital Ther. 2008;34(3):198–226. doi:10.1080/00926230701866083.

    PubMed  Google Scholar 

  11. Gates EA, Galask RP. Psychological and sexual functioning in women with vulvar vestibulitis. J Psychosom Obstet Gynaecol. 2001;22(4):221–8.

    CAS  PubMed  Google Scholar 

  12. Maillé DL, Bergeron S, Lambert B. Body image in women with primary and secondary provoked vestibulodynia: a controlled study. J Sex Med. 2014;12:505–15. doi:10.1111/jsm.12765.

    PubMed  Google Scholar 

  13. Khandker M, Brady SS, Vitonis AF, Maclehose RF, Stewart EG, Harlow BL. The influence of depression and anxiety on risk of adult onset vulvodynia. J Women's Health. 2011;20(10):1445–51. doi:10.1089/jwh.2010.2661. First study to show that depression and anxiety may precede the onset of vulvodynia.

    Google Scholar 

  14. Nguyen RH, Ecklund AM, Maclehose RF, Veasley C, Harlow BL. Co-morbid pain conditions and feelings of invalidation and isolation among women with vulvodynia. Psychol Health Med. 2012. doi:10.1080/13548506.2011.647703.

    PubMed  Google Scholar 

  15. Farmer MA, Meston CM. Predictors of genital pain in young women. Arch Sex Behav. 2007;36(6):831–43. doi:10.1007/s10508-007-9199-7.

    PubMed Central  PubMed  Google Scholar 

  16. Sutton KS, Pukall CF, Chamberlain S. Pain ratings, sensory thresholds, and psychosocial functioning in women with provoked vestibulodynia. J Sex Marital Ther. 2009;35:262–81. doi:10.1080/00926230902851256.

    PubMed  Google Scholar 

  17. Brauer M, ter Kuile MM, Laan E, Trimbos B. Cognitive-affective correlates and predictors of superficial dyspareunia. J Sex Marital Ther. 2009;35(1):1–24. doi:10.1080/00926230802525604.

    PubMed  Google Scholar 

  18. Meana M, Binik YM, Khalife S, Cohen DR. Biopsychosocial profile of women with dyspareunia. Obstet Gynecol. 1997;90(4 Pt 1):583–9.

    CAS  PubMed  Google Scholar 

  19. Cherner RA, Reissing ED. A comparative study of sexual function, behavior and cognitions of women with lifelong vaginismus. Arch Sex Behav. 2013;42:1605–14. doi:10.1007/s10508-013-0111-3.

    PubMed  Google Scholar 

  20. Masheb RM, Lozano-Blanco C, Kohorn EI, Minkin MJ, Kerns RD. Assessing sexual function and dyspareunia with the Female Sexual Function Index (FSFI) in women with vulvodynia. J Sex Marital Ther. 2004;30(5):315–24. doi:10.1080/00926230490463264.

    PubMed  Google Scholar 

  21. Reed BD, Advincula AP, Fonde KR, Gorenflo DW, Haefner HK. Sexual activities and attitudes of women with vulvar dysesthesia. Obstet Gynecol. 2003;102(2):325–31.

    PubMed  Google Scholar 

  22. Klaassen M, Ter Kuile MM. Development and initial validation of the vaginal penetration cognition questionnaire (VPCQ) in a sample of women with vaginismus and dyspareunia. J Sex Med. 2009;6(6):1617–27. doi:10.1111/j.1743-6109.2009.01217.x.

    PubMed  Google Scholar 

  23. Pazmany E, Bergeron S, Verhaeghe J, Van Oudenhove L, Enzlin P. Sexual communication, dyadic adjustment, and psychosexual well-being in premenopausal women with self-reported dyspareunia and their partners: a controlled study. J Sex Med. 2014. doi:10.1111/jsm.12518.

    Google Scholar 

  24. Nylanderlundqvist E, Bergdahl J. Vulvar vestibulitis: evidence of depression and state anxiety in patients and partners. Acta Derm Venereol. 2003;83(5):369–73.

    PubMed  Google Scholar 

  25. Smith KB, Pukall CF. Sexual function, relationship adjustment, and the relational impact of pain in male partners of women with provoked vulvar pain. J Sex Med. 2014;11(5):1283–93. doi:10.1111/jsm.12484.

    PubMed  Google Scholar 

  26. Desrosiers M, Bergeron S, Meana M, Leclerc B, Binik YM, Khalife S. Psychosexual characteristics of vestibulodynia couples: partner solicitousness and hostility are associated with pain. J Sex Med. 2008;5(2):418–27. doi:10.1111/j.1743-6109.2007.00705.x.

    PubMed  Google Scholar 

  27. Smith KB, Pukall CF. A systematic review of relationship adjustment and sexual satisfaction among women with provoked vestibulodynia. J Sex Res. 2011;48(2-3):166–91. doi:10.1080/00224499.2011.555016.

    PubMed  Google Scholar 

  28. Masheb RM, Brondolo E, Kerns RD. A multidimensional, case-control study of women with self-identified chronic vulvar pain. Pain Med. 2002;3(3):253–9. doi:10.1046/j.1526-4637.2002.02032.x (Malden, Mass).

    PubMed  Google Scholar 

  29. Hallam-Jones R, Wylie KR, Osborne-Cribb J, Harrington C, Walters S. Sexual difficulties within a group of patients with vulvodynia. Sex Relat Ther. 2001;16:113–26.

    Google Scholar 

  30. Byers ES. Relationship satisfaction and sexual satisfaction: a longitudinal study of individuals in long-term relationships. J Sex Res. 2005;42(2):113–8. doi:10.1080/00224490509552264.

    PubMed  Google Scholar 

  31. Blair KL, Pukall CF, Smith KB, Cappell J. Differential associations of communication and love in heterosexual, lesbian, and bisexual women's perceptions and experiences of chronic vulvar and pelvic pain. J Sex Marital Ther. 2014. doi:10.1080/0092623X.2014.931315.

    Google Scholar 

  32. Ponte M, Klemperer E, Sahay A, Chren MM. Effects of vulvodynia on quality of life. J Am Acad Dermatol. 2009;60(1):70–6. doi:10.1016/j.jaad.2008.06.032.

    PubMed Central  PubMed  Google Scholar 

  33. Sheppard C, Hallam-Jones R, Wylie K. Why have you both come? Emotional, relationship, sexual and social issues raised by heterosexual couples seeking sexual therapy in women referred to a sexual difficulties clinic with a history of vulval pain. Sex Relat Ther. 2008;23(3):217–26.

    Google Scholar 

  34. Elmerstig E, Wijma B, Bertero C. Why do young women continue to have sexual intercourse despite pain? J Adolesc Health Off Publ Soc Adolesc Med. 2008;43(4):357–63. doi:10.1016/j.jadohealth.2008.02.011.

    Google Scholar 

  35. Bouchard C, Brisson J, Fortier M, Morin C, Blanchette C. Use of oral contraceptive pills and vulvar vestibulitis: a case-control study. Am J Epidemiol. 2002;156(3):254–61.

    PubMed  Google Scholar 

  36. Harlow BL, Vitonis AF, Stewart EG. Influence of oral contraceptive use on the risk of adult-onset vulvodynia. J Reprod Med. 2008;53(2):102–10.

    PubMed  Google Scholar 

  37. Reed BD, Harlow SD, Legocki LJ, Helmuth ME, Haefner HK, Gillespie BW, et al. Oral contraceptive use and risk of vulvodynia: a population-based longitudinal study. BJOG. 2013;120(13):1678–84. doi:10.1111/1471-0528.12407.

    CAS  PubMed Central  PubMed  Google Scholar 

  38. Johannesson U, Blomgren B, Hilliges M, Rylander E, Bohm-Starke N. The vulval vestibular mucosa-morphological effects of oral contraceptives and menstrual cycle. Br J Dermatol. 2007;157(3):487–93. doi:10.1111/j.1365-2133.2007.08066.x.

    CAS  PubMed  Google Scholar 

  39. Bohm-Starke N, Johannesson U, Hilliges M, Rylander E, Torebjork E. Decreased mechanical pain threshold in the vestibular mucosa of women using oral contraceptives: a contributing factor in vulvar vestibulitis? J Reprod Med. 2004;49(11):888–92.

    PubMed  Google Scholar 

  40. Bohm-Starke N, Hilliges M, Falconer C, Rylander E. Increased intraepithelial innervation in women with vulvar vestibulitis syndrome. Gynecol Obstet Investig. 1998;46(4):256–60.

    CAS  Google Scholar 

  41. Goetsch MF, Morgan TK, Korcheva VB, Li H, Peters D, Leclair CM. Histologic and receptor analysis of primary and secondary vestibulodynia and controls: a prospective study. Am J Obstet Gynecol. 2010;202(6):614 e1–8. doi:10.1016/j.ajog.2010.01.028.

    PubMed  Google Scholar 

  42. Tympanidis P, Terenghi G, Dowd P. Increased innervation of the vulval vestibule in patients with vulvodynia. Br J Dermatol. 2003;148(5):1021–7.

    CAS  PubMed  Google Scholar 

  43. Bornstein J, Goldschmid N, Sabo E. Hyperinnervation and mast cell activation may be used as histopathologic diagnostic criteria for vulvar vestibulitis. Gynecol Obstet Investig. 2004;58(3):171–8. doi:10.1159/000079663.

    Google Scholar 

  44. Halperin R, Zehavi S, Vaknin Z, Ben-Ami I, Pansky M, Schneider D. The major histopathologic characteristics in the vulvar vestibulitis syndrome. Gynecol Obstet Investig. 2005;59(2):75–9. doi:10.1159/000082112.

    Google Scholar 

  45. Pukall CF, Binik YM, Khalifé S, Amsel R, Abbott FV. Vestibular tactile and pain thresholds in women with vulvar vestibulitis syndrome. Pain. 2002;96(1-2):163–75. doi:10.1016/S0304-3959(01)00442-0.

    PubMed  Google Scholar 

  46. Leclair CM, Goetsch MF, Korcheva VB, Anderson R, Peters D, Morgan TK. Differences in primary compared with secondary vestibulodynia by immunohistochemistry. Obstet Gynecol. 2011;117(6):1307–13. doi:10.1097/AOG.0b013e31821c33dc.

    PubMed Central  PubMed  Google Scholar 

  47. Lundqvist EN, Hofer PA, Olofsson JI, Sjoberg I. Is vulvar vestibulitis an inflammatory condition? A comparison of histological findings in affected and healthy women. Acta Derm Venereol. 1997;77(4):319–22.

    CAS  PubMed  Google Scholar 

  48. Farmer MA, Taylor AM, Bailey AL, Tuttle AH, MacIntyre LC, Milagrosa ZE, et al. Repeated vulvovaginal fungal infections cause persistent pain in a mouse model of vulvodynia. Sci Transl Med. 2011;3(101):101ra91. doi:10.1126/scitranslmed.3002613.

    PubMed Central  PubMed  Google Scholar 

  49. Morin M, Bergeron S, Khalife S, Mayrand MH, Binik YM. Morphometry of the pelvic floor muscles in women with and without provoked vestibulodynia using 4D ultrasound. J Sex Med. 2014;11(3):776–85. doi:10.1111/jsm.12367.

    PubMed  Google Scholar 

  50. Reissing ED, Binik YM, Khalife S, Cohen D, Amsel R. Vaginal spasm, pain, and behavior: an empirical investigation of the diagnosis of vaginismus. Arch Sex Behav. 2004;33(1):5–17. doi:10.1023/B:ASEB.0000007458.32852.c8.

    PubMed  Google Scholar 

  51. Babula O, Linhares IM, Bongiovanni AM, Ledger WJ, Witkin SS. Association between primary vulvar vestibulitis syndrome, defective induction of tumor necrosis factor-alpha, and carriage of the mannose-binding lectin codon 54 gene polymorphism. Am J Obstet Gynecol. 2008;198(1):101 e1–4. doi:10.1016/j.ajog.2007.05.037.

    PubMed  Google Scholar 

  52. Lev-Sagie A, Prus D, Linhares IM, Lavy Y, Ledger WJ, Witkin SS. Polymorphism in a gene coding for the inflammasome component NALP3 and recurrent vulvovaginal candidiasis in women with vulvar vestibulitis syndrome. Am J Obstet Gynecol. 2009;200(3):303 e1–6. doi:10.1016/j.ajog.2008.10.039.

    PubMed  Google Scholar 

  53. Gerber S, Bongiovanni AM, Ledger WJ, Witkin SS. Interleukin-1beta gene polymorphism in women with vulvar vestibulitis syndrome. Eur J Obstet Gynecol Reprod Biol. 2003;107(1):74–7.

    CAS  PubMed  Google Scholar 

  54. Heddini U, Bohm-Starke N, Gronbladh A, Nyberg F, Nilsson KW, Johannesson U. Serotonin receptor gene (5HT-2A) polymorphism is associated with provoked vestibulodynia and comorbid symptoms of pain. J Sex Med. 2014;11(12):3064–71. doi:10.1111/jsm.12685.

    CAS  PubMed  Google Scholar 

  55. Goldstein AT, Belkin ZR, Krapf JM, Song W, Khera M, Jutrzonka SL, et al. Polymorphisms of the androgen receptor gene and hormonal contraceptive induced provoked vestibulodynia. J Sex Med. 2014;11(11):2764–71. doi:10.1111/jsm.12668.

    CAS  PubMed  Google Scholar 

  56. Foster DC, Sazenski TM, Stodgell CJ. Impact of genetic variation in interleukin-1 receptor antagonist and melanocortin-1 receptor genes on vulvar vestibulitis syndrome. J Reprod Med. 2004;49(7):503–9.

    CAS  PubMed  Google Scholar 

  57. Nielsen CS, Knudsen GP, Steingrimsdottir OA. Twin studies of pain. Clin Genet. 2012;82(4):331–40. doi:10.1111/j.1399-0004.2012.01938.x.

    CAS  PubMed  Google Scholar 

  58. Landry T, Bergeron S. Biopsychosocial factors associated with dyspareunia in a community sample of adolescent girls. Arch Sex Behav. 2011;40:877–89. doi:10.1007/s10508-010-9637-9.

    PubMed  Google Scholar 

  59. Khandker M, Brady SS, Stewart EG, Harlow BL. Is chronic stress during childhood associated with adult-onset vulvodynia? J Women's Health. 2014;23(8):649–56. doi:10.1089/jwh.2013.4484.

    Google Scholar 

  60. Payne KA, Binik YM, Pukall CF, Thaler L, Amsel R, Khalifé S. Effects of sexual arousal on genital and non-genital sensation: a comparison of women with vulvar vestibulitis syndrome and healthy controls. Arch Sex Behav. 2007;36:289–300. doi:10.1007/s10508-006-9089-4.

    PubMed  Google Scholar 

  61. Aikens JE, Reed BD, Gorenflo DW, Haefner HK. Depressive symptoms among women with vulvar dysesthesia. Am J Obstet Gynecol. 2003;189(2):462–6.

    PubMed  Google Scholar 

  62. Jodoin M, Bergeron S, Khalife S, Dupuis MJ, Desrochers G, Leclerc B. Attributions about pain as predictors of psychological symptomatology, sexual function, and dyadic adjustment in women with vestibulodynia. Arch Sex Behav. 2011;40(1):87–97. doi:10.1007/s10508-010-9647-7.

    PubMed  Google Scholar 

  63. Payne KA, Binik YM, Amsel R, Khalifé S. When sex hurts, anxiety and fear orient attention towards pain. Eur J Pain. 2005;9(4):427–36. doi:10.1016/j.ejpain.2004.10.003.

    PubMed  Google Scholar 

  64. Desrochers G, Bergeron S, Khalife S, Dupuis MJ, Jodoin M. Fear avoidance and self-efficacy in relation to pain and sexual impairment in women with provoked vestibulodynia. Clin J Pain. 2009;25(6):520–7. doi:10.1097/AJP.0b013e31819976e3.

    PubMed  Google Scholar 

  65. Desrochers G, Bergeron S, Khalife S, Dupuis MJ, Jodoin M. Provoked vestibulodynia: psychological predictors of topical and cognitive-behavioral treatment outcome. Behav Res Ther. 2010;48(2):106–15. doi:10.1016/j.brat.2009.09.014.

    PubMed  Google Scholar 

  66. Davis SNP, Bergeron S, Bois K, Sadikaj G, Binik YM, Steben M. A prospective 2-year examination of cognitive and behavioral correlates of provoked vestibulodynia outcomes. Clin J Pain. 2015;31(4):333–41. doi:10.1097/ajp.0000000000000128.

    PubMed  Google Scholar 

  67. Rosen NO, Bergeron S, Glowacka M, Delisle I, 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(9):2351–60. doi:10.1111/j.1743-6109.2012.02851.x.

    PubMed  Google Scholar 

  68. Rosen NO, Bergeron S, Sadikaj G, Glowacka M, Delisle I, Baxter ML. Impact of male partner responses on sexual function in women with vulvodynia and their partners: a dyadic daily experience study. Health Psychol Off J Div Health Psychol Am Psychol Assoc. 2014;33(8):823–31. doi:10.1037/a0034550.

    Google Scholar 

  69. Rosen NO, Muise A, Bergeron S, Baxter ML, Delisle I. Daily associations between partner responses and sexual and relationship satisfaction in couples coping with provoked vestibulodynia. J Sex Med. 2015. doi:10.1111/jsm.12840.

    Google Scholar 

  70. Rosen NO, Bergeron S, Lambert B, Steben M. Provoked vestibulodynia: mediators of the associations between partner responses, pain, and sexual satisfaction. Arch Sex Behav. 2013;42(1):129–41. doi:10.1007/s10508-012-9905-y.

    PubMed  Google Scholar 

  71. Rosen NO, Bergeron S, Leclerc B, Lambert B, Steben M. Woman and partner-perceived partner responses predict pain and sexual satisfaction in provoked vestibulodynia (PVD) couples. J Sex Med. 2010;7(11):3715–24. doi:10.1111/j.1743-6109.2010.01957.x.

    PubMed  Google Scholar 

  72. Rosen NO, Bergeron S, Sadikaj G, Glowacka M, Baxter ML, Delisle I. Relationship satisfaction moderates the associations between male partner responses and depression in women with vulvodynia: a dyadic daily experience study. Pain. 2014;155(7):1374–83. doi:10.1016/j.pain.2014.04.017.

    PubMed  Google Scholar 

  73. Awada N, Bergeron S, Steben M, Hainault VA, McDuff P. To say or not to say: dyadic ambivalence over emotional expression and its associations with pain, sexuality, and distress in couples coping with provoked vestibulodynia. J Sex Med. 2014;11(5):1271–82. doi:10.1111/jsm.12463.

    PubMed  Google Scholar 

  74. Lemieux AJ, Bergeron S, Steben M, Lambert B. Do romantic partners' responses to entry dyspareunia affect women's experience of pain? The roles of catastrophizing and self-efficacy. J Sex Med. 2013. doi:10.1111/jsm.12252.

    PubMed  Google Scholar 

  75. Boerner KE, Rosen NO. Acceptance of vulvovaginal pain in women with provoked vestibulodynia and their partners: associations with pain, psychological, and sexual adjustment. J Sex Med. 2015. doi:10.1111/jsm.12889.

    PubMed  Google Scholar 

  76. Jodoin M, Bergeron S, Khalifé S, Dupuis M-J, Desrochers G, Leclerc B. Male partners of women with provoked vestibulodynia: attributions for pain and their implications for dyadic adjustment, sexual satisfaction, and psychological distress. J Sex Med. 2008;5:2862–70. doi:10.1111/j.1743-6109.2008.00950.x.

    PubMed  Google Scholar 

  77. Rosen NO, Sadikaj G, Bergeron S. Within-person variability in relationship satisfaction moderates partners' pain estimation in vulvodynia couples. Pain. 2015;156(4):703–10. doi:10.1097/j.pain.0000000000000101.

    PubMed  Google Scholar 

  78. Granot M, Zisman-Ilani Y, Ram E, Goldstick O, Yovell Y. Characteristics of attachment style in women with dyspareunia. J Sex Marital Ther. 2011;37(1):1–16. doi:10.1080/0092623x.2011.533563.

    PubMed  Google Scholar 

  79. Pazmany E, Bergeron S, Verhaeghe J, Van Oudenhove L, Enzlin P. Dyadic sexual communication in pre-menopausal women with self-reported dyspareunia and their partners: associations with sexual function, sexual distress and dyadic adjustment. J Sex Med. 2015;12(2):516–28. doi:10.1111/jsm.12787.

    PubMed  Google Scholar 

  80. Leclerc B, Bergeron S, Brassard A, Belanger C, Steben M, Lambert B. Attachment, sexual assertiveness, and sexual outcomes in women with provoked vestibulodynia and their partners: a mediation model. Arch Sex Behav. 2014. doi:10.1007/s10508-014-0295-1.

    PubMed  Google Scholar 

  81. Bois K, Bergeron S, Rosen NO, McDuff P, Gregoire C. Sexual and relationship intimacy among women with provoked vestibulodynia and their partners: associations with sexual satisfaction, sexual function, and pain self-efficacy. J Sex Med. 2013;10(8):2024–35. doi:10.1111/jsm.12210.

    PubMed  Google Scholar 

  82. Bois K, Bergeron S, Rosen N, Mayrand M-H, Brassard A, Sadikaj G. Intimacy process, sexual satisfaction and sexual distress in vulvodynia couples: an observational study. Health Psychol Off J Div Health Psychol Am Psychol Assoc. revision submitted.

  83. Rosen NO, Muise A, Bergeron S, Impett E, Boudreau G. Approach and avoidance sexual goals in women with provoked vestibulodynia and their partners: associations with sexual, relationship and psychological well-being. J Sex Med. revision requested.

  84. Nyirjesy P, Sobel JD, Weitz MV, Leaman DJ, Small MJ, Gelone SP. Cromolyn cream for recalcitrant idiopathic vulvar vestibulitis: results of a placebo controlled study. Sex Transm Infect. 2001;77(1):53–7.

    CAS  PubMed Central  PubMed  Google Scholar 

  85. Bornstein J, Tuma R, Farajun Y, Azran A, Zarfati D. Topical nifedipine for the treatment of localized provoked vulvodynia: a placebo-controlled study. J Pain. 2010;11(12):1403–9. doi:10.1016/j.jpain.2010.03.016.

    CAS  PubMed  Google Scholar 

  86. Petersen CD, Giraldi A, Lundvall L, Kristensen E. Botulinum toxin type A-a novel treatment for provoked vestibulodynia? Results from a randomized, placebo controlled, double blinded study. J Sex Med. 2009;6(9):2523–37. doi:10.1111/j.1743-6109.2009.01378.x.

    CAS  PubMed  Google Scholar 

  87. Foster DC, Kotok MB, Huang LS, Watts A, Oakes D, Howard FM, et al. Oral desipramine and topical lidocaine for vulvodynia: a randomized controlled trial. Obstet Gynecol. 2010;116(3):583–93. doi:10.1097/AOG.0b013e3181e9e0ab.

    CAS  PubMed  Google Scholar 

  88. Davis SN, Bergeron S, Binik YM, Lambert B. Women with provoked vestibulodynia experience clinically significant reductions in pain regardless of treatment: results from a 2-year follow-up study. J Sex Med. 2013;10(12):3080–7. doi:10.1111/jsm.12309.

    PubMed  Google Scholar 

  89. Zolnoun DA, Hartmann KE, Steege JF. Overnight 5% lidocaine ointment for treatment of vulvar vestibulitis. Obstet Gynecol. 2003;102(1):84–7.

    CAS  PubMed  Google Scholar 

  90. Steinberg AC, Oyama IA, Rejba AE, Kellogg-Spadt S, Whitmore KE. Capsaicin for the treatment of vulvar vestibulitis. Am J Obstet Gynecol. 2005;192(5):1549–53. doi:10.1016/j.ajog.2004.10.626.

    CAS  PubMed  Google Scholar 

  91. Stockdale CK, Lawson HW. 2013 Vulvodynia Guideline update. J Low Genit Tract Dis. 2014;18(2):93–100. doi:10.1097/LGT.0000000000000021.

    PubMed  Google Scholar 

  92. Burrows LJ, Goldstein AT. The treatment of vestibulodynia with topical estradiol and testosterone. Sex Med. 2013;1(1):30–3. doi:10.1002/sm2.4.

    CAS  PubMed Central  PubMed  Google Scholar 

  93. Leo RJ. A systematic review of the utility of anticonvulsant pharmacotherapy in the treatment of vulvodynia pain. J Sex Med. 2013;10(8):2000–8. doi:10.1111/jsm.12200.

    PubMed  Google Scholar 

  94. Segal D, Tifheret H, Lazer S. Submucous infiltration of betamethasone and lidocaine in the treatment of vulvar vestibulitis. Eur J Obstet Gynecol Reprod Biol. 2003;107(1):105–6.

    PubMed  Google Scholar 

  95. Landry T, Bergeron S, Dupuis MJ, Desrochers G. The treatment of provoked vestibulodynia: a critical review. Clin J Pain. 2008;24(2):155–71. doi:10.1097/AJP.0b013e31815aac4d.

    PubMed  Google Scholar 

  96. Bergeron S, Khalife S, Glazer HI, Binik YM. Surgical and behavioral treatments for vestibulodynia: two-and-one-half year follow-up and predictors of outcome. Obstet Gynecol. 2008;111(1):159–66. doi:10.1097/01.AOG.0000295864.76032.a7.

    PubMed  Google Scholar 

  97. Rosenbaum T. Physical therapy management and treatment of sexual pain disorders. 4 Ed. Principles and practice of sex therapy. New York: The Guilford Press; 2007.

    Google Scholar 

  98. Bergeron S, Morin M, Lord M-J. Integrating pelvic floor rehabilitation and cognitive-behavioral therapy for sexual pain: what have we learned and where do we go from here? Sex Relat Ther. 2010;25:304–13.

    Google Scholar 

  99. FitzGerald MP, Kotarinos R. Rehabilitation of the short pelvic floor. II: treatment of the patient with the short pelvic floor. Int Urogynecol J Pelvic Floor Dysfunct. 2003;14(4):269–75. doi:10.1007/s00192-003-1050-7. discussion 75.

    CAS  PubMed  Google Scholar 

  100. Rosenbaum TY, Owens A. The role of pelvic floor physical therapy in the treatment of pelvic and genital pain-related sexual dysfunction (CME). J Sex Med. 2008;5(3):513–23. doi:10.1111/j.1743-6109.2007.00761.x. quiz 24-5.

    PubMed  Google Scholar 

  101. Glazer HI, Rodke G, Swencionis C, Hertz R, Young AW. Treatment of vulvar vestibulitis syndrome with electromyographic biofeedback of pelvic floor musculature. J Reprod Med. 1995;40(4):283–90.

    CAS  PubMed  Google Scholar 

  102. Glazer HI. Dysesthetic vulvodynia. Long-term follow-up after treatment with surface electromyography-assisted pelvic floor muscle rehabilitation. J Reprod Med. 2000;45(10):798–802.

    CAS  PubMed  Google Scholar 

  103. Danielsson I, Torstensson T, Brodda-Jansen G, Bohm-Starke N. EMG biofeedback versus topical lidocaine gel: a randomized study for the treatment of women with vulvar vestibulitis. Acta Obstet Gynecol Scand. 2006;85(11):1360–7. doi:10.1080/00016340600883401.

    PubMed  Google Scholar 

  104. Nappi RE, Ferdeghini F, Abbiati I, Vercesi C, Farina C, Polatti F. Electrical stimulation (ES) in the management of sexual pain disorders. J Sex Marital Ther. 2003;29 Suppl 1:103–10. doi:10.1080/713847129.

    PubMed  Google Scholar 

  105. Fitzwater JB, Kuehl TJ, Schrier JJ. Electrical stimulation in the treatment of pelvic pain due to levator ani spasm. J Reprod Med. 2003;48(8):573–7.

    PubMed  Google Scholar 

  106. Murina F, Bianco V, Radici G, Felice R, Di Martino M, Nicolini U. Transcutaneous electrical nerve stimulation to treat vestibulodynia: a randomised controlled trial. BJOG. 2008;115(9):1165–70. doi:10.1111/j.1471-0528.2008.01803.x.

    CAS  PubMed  Google Scholar 

  107. Bergeron S, Brown C, Lord MJ, Oala M, Binik YM, Khalife S. Physical therapy for vulvar vestibulitis syndrome: a retrospective study. J Sex Marital Ther. 2002;28(3):183–92.

    PubMed  Google Scholar 

  108. Gentilcore-Saulnier E, McLean L, Goldfinger C, Pukall CF, Chamberlain S. Pelvic floor muscle assessment outcomes in women with and without provoked vestibulodynia and the impact of a physical therapy program. J Sex Med. 2010;7(2 Pt 2):1003–22. doi:10.1111/j.1743-6109.2009.01642.x.

    PubMed  Google Scholar 

  109. Goldfinger C, Pukall CF, Gentilcore-Saulnier E, McLean L, Chamberlain S. A prospective study of pelvic floor physical therapy: pain and psychosexual outcomes in provoked vestibulodynia. J Sex Med. 2009;6(7):1955–68. doi:10.1111/j.1743-6109.2009.01304.x.

    PubMed  Google Scholar 

  110. Bergeron S, Binik YM, Khalife S, Pagidas K, Glazer HI, Meana M, et al. A randomized comparison of group cognitive–behavioral therapy, surface electromyographic biofeedback, and vestibulectomy in the treatment of dyspareunia resulting from vulvar vestibulitis. Pain. 2001;91(3):297–306.

    CAS  PubMed  Google Scholar 

  111. Engman M, Wijma K, Wijma B. Long-term coital behaviour in women treated with cognitive behaviour therapy for superficial coital pain and vaginismus. Cogn Behav Ther. 2010;39(3):193–202. doi:10.1080/16506070903571014.

    PubMed  Google Scholar 

  112. Masheb RM, Kerns RD, Lozano C, Minkin MJ, Richman S. A randomized clinical trial for women with vulvodynia: cognitive-behavioral therapy vs. supportive psychotherapy. Pain. 2009;141:31–40. doi:10.1016/j.pain.2008.09.031.

    PubMed Central  PubMed  Google Scholar 

  113. van Lankveld JJ, ter Kuile MM, de Groot HE, Melles R, Nefs J, Zandbergen M. Cognitive-behavioral therapy for women with lifelong vaginismus: a randomized waiting-list controlled trial of efficacy. J Consult Clin Psychol. 2006;74(1):168–78. doi:10.1037/0022-006x.74.1.168.

    PubMed  Google Scholar 

  114. ter Kuile MM, Melles R, de Groot HE, Tuijnman-Raasveld CC, van Lankveld JJ. Therapist-aided exposure for women with lifelong vaginismus: a randomized waiting-list control trial of efficacy. J Consult Clin Psychol. 2013;81(6):1127–36. doi:10.1037/a0034292.

    PubMed  Google Scholar 

  115. Kabat-Zinn J, Lipworth L, Burney R. The clinical use of mindfulness meditation for the self-regulation of chronic pain. J Behav Med. 1985;8:163–90.

    CAS  PubMed  Google Scholar 

  116. McCracken LM, Carson JW, Eccleston C, Keefe FJ. Acceptance and change in the context of chronic pain. Pain. 2004;109:4–7. doi:10.1016/j.pain.2004.02.006.

    PubMed  Google Scholar 

  117. Brotto LA, Basson R, Carlson M, Zhu C. Impact of an integrated mindfulness and cognitive behavioral treatment for provoked vestibulodynia (IMPROVED): a qualitative study. Sex Relat Ther. 2013;28(1-2):3–19. doi:10.1080/14681994.2012.686661.

    Google Scholar 

  118. Brotto LA, Basson R, Smith KB, Driscoll M, Sadownik L. Mindfulness-based group therapy for women with provoked vestibulodynia. Mindfulness. 2014:1-16. doi:10.1007/s12671-013-0273-z.

  119. Corsini-Munt S, Bergeron S, Rosen NO, Mayrand MH, Delisle I. Feasibility and preliminary effectiveness of a novel cognitive-behavioral couple therapy for provoked vestibulodynia: a pilot study. J Sex Med. 2014;11(10):2515–27. doi:10.1111/jsm.12646.

    PubMed  Google Scholar 

  120. Fugl-Meyer KS, Bohm-Starke N, Damsted Petersen C, Fugl-Meyer A, Parish S, Giraldi A. Standard operating procedures for female genital sexual pain. J Sex Med. 2013;10(1):83–93. doi:10.1111/j.1743-6109.2012.02867.x.

    PubMed  Google Scholar 

  121. Brotto LA, Yong P, Smith KB, Sadownik LA. Impact of a multidisciplinary vulvodynia program on sexual functioning and dyspareunia. J Sex Med. 2015;12(1):238–47. doi:10.1111/jsm.12718.

    PubMed  Google Scholar 

  122. Yong PJ, Sadownik L, Brotto LA. Concurrent deep-superficial dyspareunia: prevalence, associations, and outcomes in a multidisciplinary vulvodynia program. J Sex Med. 2015;12(1):219–27. doi:10.1111/jsm.12729.

    PubMed  Google Scholar 

  123. Backman H, Widenbrant M, Bohm-Starke N, Dahlof LG. Combined physical and psychosexual therapy for provoked vestibulodynia-an evaluation of a multidisciplinary treatment model. J Sex Res. 2008;45(4):378–85. doi:10.1080/00224490802398365.

    PubMed  Google Scholar 

  124. Spoelstra SK, Dijkstra JR, van Driel MF, Weijmar Schultz WC. Long-term results of an individualized, multifaceted, and multidisciplinary therapeutic approach to provoked vestibulodynia. J Sex Med. 2011;8(2):489–96. doi:10.1111/j.1743-6109.2010.01941.x.

    PubMed  Google Scholar 

  125. Sadownik LA, Seal BN, Brotto LA. Provoked vestibulodynia-women’s experience of participating in a multidisciplinary vulvodynia program. J Sex Med. 2012;9(4):1086–93. doi:10.1111/j.1743-6109.2011.02641.x.

    PubMed  Google Scholar 

  126. Munday P, Buchan A, Ravenhill G, Wiggs A, Brooks F. A qualitative study of women with vulvodynia: II. Response to a multidisciplinary approach to management. J Reprod Med. 2007;52(1):19–22.

    PubMed  Google Scholar 

  127. Ledermann T, Kenny DA. The common fate model for dyadic data: variations of a theoretically important but underutilized model. J Fam Psychol JFP J Div Fam Psychol Am Psychol Assoc (Division 43). 2012;26(1):140–8. doi:10.1037/a0026624.

    Google Scholar 

Download references

Compliance with Ethics Guidelines

ᅟ

Conflict of Interest

Sophie Bergeron, Serena Corsini-Munt, Leen Aerts, Kate Rancourt, and Natalie O. Rosen declare no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

  1. Department of Psychology, Université de Montréal, C.P. 6128, succursale Centre-Ville, Montréal, Quebec, H3C 3J7, Canada

    Sophie Bergeron, Serena Corsini-Munt & Leen Aerts

  2. Department of Psychology and Neuroscience, Life Sciences Centre, Dalhousie University, 1355 Oxford Street, Halifax, B3H 4R2, Canada

    Kate Rancourt & Natalie O. Rosen

  3. Department of Obstetrics and Gynecology, IWK Health Centre, 5980 University Avenue, Halifax, Nova Scotia, B3K 6R8, Canada

    Natalie O. Rosen

Authors
  1. Sophie Bergeron
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Serena Corsini-Munt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Leen Aerts
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kate Rancourt
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Natalie O. Rosen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sophie Bergeron.

Additional information

This article is part of the Topical Collection on Male Sexual Dysfunction and Disorders

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bergeron, S., Corsini-Munt, S., Aerts, L. et al. Female Sexual Pain Disorders: a Review of the Literature on Etiology and Treatment. Curr Sex Health Rep 7, 159–169 (2015). https://doi.org/10.1007/s11930-015-0053-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11930-015-0053-y

Keywords

Search

Navigation