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Maintaining Affection Despite Pain: Daily Associations Between Physical Affection and Sexual and Relationship Well-Being in Women with Genito-Pelvic Pain

Abstract

Provoked vestibulodynia (PVD) is a recurrent, genito-pelvic pain condition that affects 8–12 % of women and has negative implications for sexual and relationship functioning. Many women with PVD report avoiding physical affection because they are concerned that affectionate behavior will lead to painful sexual activity. In community samples, physical affection is associated with improved sexual and relational well-being; however, no research has assessed the influence of physical affection on well-being in women with PVD. The current study examined day-to-day, within-person associations between affectionate behavior (hugging/kissing, cuddling) and sexual satisfaction, relationship satisfaction, sexual functioning, and pain intensity in women with PVD. Seventy women diagnosed with PVD completed an 8-week daily survey. Data were analyzed using multilevel modeling. All outcomes were assessed on days involving sexual activity (n = 401 days). Physical affection was assessed on days with and without sexual activity. Hugging/kissing was positively associated with sexual satisfaction, relationship satisfaction, and sexual functioning within any given day and when predicting the next day. Hugging/kissing was unrelated to pain intensity. Cuddling was not associated with any outcomes. Results persisted for affection that occurred on days with and without sexual activity. Findings suggest physical affection is beneficial for the sexual and relationship well-being of women with PVD. These results may inform interventions that encourage women coping with PVD to engage in more daily physical affection with their partners.

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References

  • Abelson, R. P. (1985). A variance explanation paradox: When a little is a lot. Psychological Bulletin, 97, 129–133. doi:10.1037/0033-2909.97.1.129.

    Article  Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.

    Google Scholar 

  • Arnold, L. D., Bachmann, G. A., Kelly, S., Rosen, R., & Rhoads, G. G. (2006). Vulvodynia: Characteristics and associations with co-morbidities and quality of life. Obstetrics and Gynecology, 107, 617–624. doi:10.1097/01.AOG.0000199951.26822.27.

    Article  PubMed  PubMed Central  Google Scholar 

  • Atkins, D. C., Baldwin, S. A., Zheng, C., Gallop, R. J., & Neighbors, C. (2013). A tutorial on count regression and zero-altered count models for longitudinal substance use data. Psychology of Addictive Behaviors, 27, 166–177. doi:10.1037/a0029508.

    Article  PubMed  Google Scholar 

  • Ayling, K., & Ussher, J. M. (2008). ‘If sex hurts, am I still a woman?’ The subjective experience of vulvodynia in hetero-sexual women. Archives of Sexual Behavior, 37, 294–304. doi:10.1007/s10508-007-9204-1.

    Article  PubMed  Google Scholar 

  • Basson, R. (2012). The recurrent pain and sexual sequelae of provoked vestibulodynia: A perpetuating cycle. Journal of Sexual Medicine, 9, 2077–2092. doi:10.1111/j.1743-6109.2012.02803.x.

    Article  PubMed  Google Scholar 

  • Bergeron, S., Binik, Y. M., Khalifé, S., Pagidas, K., & Glazer, H. I. (2001). Vulvar vestibulitis syndrome: Reliability of diagnosis and evaluation of current diagnostic criteria. Obstetrics and Gynecology, 98, 45–51. doi:10.1016/S0029-7844(01)01389-8.

    PubMed  Google Scholar 

  • Bergeron, S., Rosen, N. O., & Morin, M. (2011). Genital pain in women: Beyond interference with intercourse. Pain, 152, 1223–1225. doi:10.1016/j.pain.2011.01.035.

    Article  PubMed  Google Scholar 

  • Blair, K. L., Pukall, C. F., Smith, K. B., & Cappell, J. (2015). Differential associations of communication and love in heterosexual, lesbian, and bisexual women’s perceptions and experiences of chronic vulvar and pelvic pain. Journal of Sex and Marital Therapy, 41, 498–524. doi:10.1080/0092623X.2014.931315.

    Article  PubMed  Google Scholar 

  • Bois, K., Bergeron, S., Rosen, N. O., Mayrand, M. H., Brassard, A., & Sadikaj, G. (2016). Intimacy, sexual satisfaction, and sexual distress in vulvodynia couples: An observational study. Health Psychology, 35, 531–540. doi:10.1037/hea0000289.

    Article  PubMed  Google Scholar 

  • Bois, K., Bergeron, S., Rosen, N. O., McDuff, P., & Grégoire, C. (2013). Sexual and relationship intimacy among women with provoked vestibulodynia and their partners: Associations with sexual satisfaction, sexual function, and pain self-efficacy. Journal of Sexual Medicine, 10, 2024–2035. doi:10.1111/jsm.12210.

    Article  PubMed  Google Scholar 

  • Brotto, L. A., Yong, P., Smith, K. B., & Sadownik, L. A. (2015). Impact of a multidisciplinary vulvodynia program on sexual functioning and dyspareunia. Journal of Sexual Medicine, 12, 238–247. doi:10.1111/jsm.12718.

    Article  PubMed  Google Scholar 

  • Burleson, M. H., Trevathan, W. R., & Todd, M. (2007). In the mood for love or vice versa? Exploring the relations among sexual activity, physical affection, affect, and stress in the daily lives of mid-aged women. Archives of Sexual Behavior, 36, 357–368. doi:10.1007/s10508-006-9071-1.

    Article  PubMed  Google Scholar 

  • Cherner, R. A., & Reissing, E. D. (2013). A comparative study of sexual function, behavior, and cognitions of women with lifelong vaginismus. Archives of Sexual Behavior, 42, 1605–1614. doi:10.1007/s10508-013-0111-3.

    Article  PubMed  Google Scholar 

  • Crombez, G., Eccleston, C., Van Damme, S., Vlaeyen, J. W., & Karoly, P. (2012). Fear-avoidance model of chronic pain: The next generation. Clinical Journal of Pain, 28, 475–483. doi:10.1097/AJP.0b013e3182385392.

    Article  PubMed  Google Scholar 

  • Dainton, M., Stafford, L., & Canary, D. J. (1994). Maintenance strategies and physical affection as predictors of love, liking, and satisfaction in marriage. Communication Reports, 7, 88–98. doi:10.1080/08934219409367591.

    Article  Google Scholar 

  • Davison, S. L., Bell, R. J., La China, M., Holden, S. L., & Davis, S. R. (2008). Assessing sexual function in well women: Validity and reliability of the Monash women’s health program female sexual satisfaction questionnaire. Journal of Sexual Medicine, 5, 2575–2586. doi:10.1111/j.1743-6109.2008.00967.x.

    Article  PubMed  Google Scholar 

  • Debrot, A., Schoebi, D., Perrez, M., & Horn, A. B. (2013). Touch as an interpersonal emotion regulation process in couples’ daily lives: The mediating role of psychological intimacy. Personality and Social Psychology Bulletin, 39, 1373–1385. doi:10.1177/0146167213497592.

    Article  PubMed  Google Scholar 

  • Desrochers, G., Bergeron, S., Khalifé, S., Dupuis, M. J., & Jodoin, M. (2009). Fear avoidance and self-efficacy in relation to pain and sexual impairment in women with provoked vestibulodynia. Clinical Journal of Pain, 25, 520–527. doi:10.1097/AJP.0b013e31819976e3.

    Article  PubMed  Google Scholar 

  • Ditzen, B., Neumann, I. D., Bodenmann, G., von Dawans, B., Turner, R. A., Ehlert, U., & Heinrichs, M. (2007). Effects of different kinds of couple interaction on cortisol and heart rate responses to stress in women. Psychoneuroendocrinology, 32, 565–574. doi:10.1016/j.psyneuen.2007.03.011.

    Article  PubMed  Google Scholar 

  • Ehrström, S., Kornfeld, D., Rylander, E., & Bohm-Starke, N. (2009). Chronic stress in women with localised provoked vulvodynia. Journal of Psychosomatic Obstetrics & Gynecology, 30, 73–79. doi:10.1080/01674820802604359.

    Article  Google Scholar 

  • Elmerstig, E., Wijma, B., & Berterö, C. (2008). Why do young women continue to have sexual intercourse despite pain? Journal of Adolescent Health, 43, 357–363. doi:10.1016/j.jadohealth.2008.02.011.

    Article  PubMed  Google Scholar 

  • Emmers, T. M., & Dindia, K. (1995). The effect of relational stage and intimacy on touch: An extension of Guerrero and Andersen. Personal Relationships, 2, 225–236. doi:10.1111/j.1475-6811.1995.tb00088.x.

    Article  Google Scholar 

  • Fisher, W. A., Donahue, K. L., Long, J. S., Heiman, J. R., Rosen, R. C., & Sand, M. S. (2015). Individual and partner correlates of sexual satisfaction and relationship happiness in midlife couples: Dyadic analysis of the international survey of relationships. Archives of Sexual Behavior, 44, 1609–1620. doi:10.1007/s10508-014-0426-8.

    Article  PubMed  Google Scholar 

  • Floyd, K. (2002a). Communicating affection: Interpersonal behavior and social context. Cambridge, England: Cambridge University Press.

    Google Scholar 

  • Floyd, K. (2002b). Human affection exchange: V. Attributes of the highly affectionate. Communication Quarterly, 50, 135–192. doi:10.1080/01463370209385653.

    Article  Google Scholar 

  • Galinsky, A. M. (2012). Sexual touching and difficulties with sexual arousal and orgasm among US older adults. Archives of Sexual Behavior, 41, 875–890. doi:10.1007/s10508-011-9873-7.

    Article  PubMed  Google Scholar 

  • Gates, E. A., & Galask, R. P. (2001). Psychological and sexual functioning in women with vulvar vestibulitis. Journal of Psychosomatic Obstetrics and Gynecology, 22, 221–228. doi:10.3109/01674820109049977.

    Article  PubMed  Google Scholar 

  • Geldhof, G. J., Preacher, K. J., & Zyphur, M. J. (2014). Reliability estimation in a multilevel confirmatory factor analysis framework. Psychological Methods, 19, 72–91. doi:10.1037/a0032138.

    Article  PubMed  Google Scholar 

  • Grewen, K. M., Anderson, B. J., Girdler, S. S., & Light, K. C. (2004). Warm partner contact is related to lower cardiovascular reactivity. Behavioral Medicine, 29, 123–130. doi:10.1080/08964280309596065.

    Article  Google Scholar 

  • Gulledge, A. K., Gulledge, M. H., & Stahmann, R. F. (2003). Romantic physical affection types and relationship satisfaction. American Journal of Family Therapy, 31, 233–242. doi:10.1080/01926180390201936.

    Article  Google Scholar 

  • Harlow, B. L., Kunitz, C. G., Nguyen, R. H. N., Rydell, S. A., Turner, R. M., & MacLehose, R. F. (2014). Prevalence of symptoms consistent with a diagnosis of vulvodynia: population-based estimates from 2 geographic regions. American Journal of Obstetrics and Gynecology, 210, 40–42. doi:10.1016/j.ajog.2013.09.033.

    Article  PubMed  Google Scholar 

  • Harlow, B. L., Wise, L. A., & Stewart, E. G. (2001). Prevalence and predictors of chronic lower genital tract discomfort. American Journal of Obstetrics and Gynecology, 185, 545–550. doi:10.1067/mob.2001.116748.

    Article  PubMed  Google Scholar 

  • Heiman, J. R., Long, J. S., Smith, S. N., Fisher, W. A., Sand, M. S., & Rosen, R. C. (2011). Sexual satisfaction and relationship happiness in midlife and older couples in five countries. Archives of Sexual Behavior, 40, 741–753. doi:10.1007/s10508-010-9703-3.

    Article  PubMed  Google Scholar 

  • Hinchliff, S., Gott, M., & Wylie, K. (2012). A qualitative study of heterosexual women’s attempts to renegotiate sexual relationships in the context of severe sexual problems. Archives of Sexual Behavior, 41, 1253–1261. doi:10.1007/s10508-012-9903-0.

    Article  PubMed  Google Scholar 

  • Horan, S. M., & Booth-Butterfield, M. (2010). Investing in affection: An investigation of affection exchange theory and relational qualities. Communication Quarterly, 58, 394–413. doi:10.1080/01463373.2010.524876.

    Article  Google Scholar 

  • Kutner, J. S., Smith, M. C., Corbin, L., Hemphill, L., Benton, K., Mellis, B. K., & Fairclough, D. L. (2008). Massage therapy versus simple touch to improve pain and mood in patients with advanced cancer: A randomized trial. Annals of Internal Medicine, 149, 369–379.

    Article  PubMed  PubMed Central  Google Scholar 

  • L’Abate, L. (2007). Hugging, holding, huddling, and cuddling (3HC): A task prescription in couple and family therapy. In L. L. Hecker, C. F. Sori, L. L. Hecker, & C. F. Sori (Eds.), The therapist’s notebook: More homework, handouts, and activities for use in psychotherapy (Vol. 2, pp. 47–55). New York: Haworth Press.

    Google Scholar 

  • Lawrance, K. A., & Byers, E. S. (1995). Sexual satisfaction in long-term heterosexual relationships: The Interpersonal Exchange Model of Sexual Satisfaction. Personal Relationships, 2, 267–285. doi:10.1111/j.1475-6811.1995.tb00092.x.

    Article  Google Scholar 

  • Leclerc, B., Bergeron, S., Brassard, A., Bélanger, C., Steben, M., & Lambert, B. (2014). Attachment, sexual assertiveness, and sexual outcomes in women with provoked vestibulodynia and their partners: A mediation model. Archives of Sexual Behavior, 44, 1561–1572. doi:10.1007/s10508-014-0295-1.

    Article  PubMed  Google Scholar 

  • Mackey, R. A., Diemer, M. A., & O’Brien, B. A. (2000). Psychological intimacy in the lasting relationships of heterosexual and same-gender couples. Sex Roles, 43, 201–227. doi:10.1023/A:1007028930658.

    Article  Google Scholar 

  • Marriott, C., & Thompson, A. R. (2008). Managing threats to femininity: Personal and interpersonal experience of living with vulval pain. Psychology and Health, 23, 243–258. doi:10.1080/14768320601168185.

    Article  PubMed  Google Scholar 

  • Masheb, R. M., Lozano-Blanco, C., Kohorn, E. I., Minkin, M. J., & Kerns, R. D. (2004). Assessing sexual function and dyspareunia with the Female Sexual Function Index (FSFI) in women with vulvodynia. Journal of Sex and Marital Therapy, 30, 315–324. doi:10.1080/00926230490463264.

    Article  PubMed  Google Scholar 

  • McAuliffe, T. L., DiFranceisco, W., & Reed, B. R. (2007). Effects of question format and collection mode on the accuracy of retrospective surveys of health risk behavior: A comparison with daily sexual activity diaries. Health Psychology, 26, 60–67. doi:10.1037/0278-6133.26.1.60.

    Article  PubMed  Google Scholar 

  • McCarthy, B., & Farr, E. (2012). Strategies and techniques to maintain sexual desire. Journal of Contemporary Psychotherapy, 42, 227–233. doi:10.1007/s10879-012-9207-7.

    Article  Google Scholar 

  • Meana, M., Binik, Y. M., Khalife, S., & Cohen, D. R. (1997). Biopsychosocial profile of women with dyspareunia. Obstetrics and Gynecology, 90, 583–589. doi:10.1016/S0029-7844(98)80136-1.

    Article  PubMed  Google Scholar 

  • Mitchell, K. R., King, M., Nazareth, I., & Wellings, K. (2011). Managing sexual difficulties: A qualitative investigation of coping strategies. Journal of Sex Research, 48, 325–333. doi:10.1080/00224499.2010.494332.

    Article  PubMed  Google Scholar 

  • Moyal-Barracco, M., & Lynch, P. J. (2004). 2003 ISSVD terminology and classification of vulvodynia: A historical perspective. Journal of Reproductive Medicine for the Obstetrician and Gynecologist, 49, 772–777.

    PubMed  Google Scholar 

  • Muise, A., Giang, E., & Impett, E. A. (2014). Post sex affectionate exchanges promote sexual and relationship satisfaction. Archives of Sexual Behavior, 43, 1391–1402. doi:10.1007/s10508-014-0305-3.

    Article  PubMed  Google Scholar 

  • Muthén, L. K. M., & Muthén, B. O. (2012). The comprehensive modelling program for applied researchers: User’s guide, 5. Los Angeles, CA: Author.

  • Nylanderlundqvist, E., & Bergdahl, J. (2003). Vulvar vestibulitis: Evidence of depression and state anxiety in patients and partners. Acta Dermato-Venereologica, 83, 369–373. doi:10.1080/00015550310003764.

    Article  PubMed  Google Scholar 

  • Payne, K. A., Binik, Y. M., Amsel, R., & Khalifé, S. (2005). When sex hurts, anxiety and fear orient attention towards pain. European Journal of Pain, 9, 427–436. doi:10.1016/j.ejpain.2004.10.003.

    Article  PubMed  Google Scholar 

  • Payne, K. A., Binik, Y. M., Pukall, C. F., Thaler, L., Amsel, R., & Khalifé, S. (2007). Effects of sexual arousal on genital and non-genital sensation: A comparison of women with vulvar vestibulitis syndrome and healthy controls. Archives of Sexual Behavior, 36, 289–300. doi:10.1007/s10508-006-9089-4.

    Article  PubMed  Google Scholar 

  • Ponte, M., Klemperer, E., Sahay, A., & Chren, M. M. (2009). Effects of vulvodynia on quality of life. Journal of the American Academy of Dermatology, 60, 70–76. doi:10.1016/j.jaad.2008.06.032.

    Article  PubMed  Google Scholar 

  • Preacher, K. J., Zyphur, M. J., & Zhang, Z. (2010). A general multilevel SEM framework for assessing multilevel mediation. Psychological Methods, 15, 209–233. doi:10.1037/a0020141.

    Article  PubMed  Google Scholar 

  • Rancourt, K. M., Rosen, N. O., Bergeron, S., & Nealis, L. J. (2016). Talking about sex when sex is painful: Dyadic sexual communication is associated with women’s pain, and couples’ sexual and psychological outcomes in provoked vestibulodynia. Archives of Sexual Behavior. doi:10.1007/s10508-015-0670-6.

    PubMed  Google Scholar 

  • Rosen, N. O., Bergeron, S., Glowacka, M., Delisle, I., & Baxter, M. L. (2012). Harmful or helpful: Perceived solicitous and facilitative partner responses are differentially associated with pain and sexual satisfaction in women with provoked vestibulodynia. Journal of Sexual Medicine, 9, 2351–2360. doi:10.1111/j.1743-6109.2012.02851.x.

    Article  PubMed  Google Scholar 

  • Rosen, N. O., Bergeron, S., Sadikaj, G., & Delisle, I. (2015a). Daily associations among male partner responses, pain during intercourse, and anxiety in women with vulvodynia and their partners. Journal of Pain, 16, 1312–1320. doi:10.1016/j.jpain.2015.09.003.

    Article  PubMed  Google Scholar 

  • Rosen, N. O., Bergeron, S., Sadikaj, G., Glowacka, M., Baxter, M.-L., & Delisle, I. (2014a). Relationship satisfaction moderates the associations between male partner responses and depression in women with vulvodynia: A dyadic daily experience study. Pain, 155, 1374–1383. doi:10.1016/j.pain.2014.04.017.

    Article  PubMed  Google Scholar 

  • Rosen, N. O., Bergeron, S., Sadikaj, G., Glowacka, M., Delisle, I., & Baxter, M.-L. (2014b). Impact of male partner responses on sexual function in women with vulvodynia and their partners: A dyadic daily experience study. Health Psychology, 33, 823–831. doi:10.1037/a0034550.

    Article  PubMed  Google Scholar 

  • Rosen, N. O., Muise, A., Bergeron, S., Delisle, I., & Baxter, M. L. (2015b). Daily associations between partner responses and sexual and relationship satisfaction in couples coping with provoked vestibulodynia. Journal of Sexual Medicine, 12, 1028–1039. doi:10.1111/jsm.12840.

    Article  PubMed  Google Scholar 

  • Rosen, N. O., Sadikaj, G., & Bergeron, S. (2015c). Within-person variability in relationship satisfaction moderates partners’ pain estimation in vulvodynia couples. Pain, 156, 703–710. doi:10.1097/j.pain.0000000000000101.

    Article  PubMed  Google Scholar 

  • Rubin, H., & Campbell, L. (2012). Day-to-day changes in intimacy predict heightened relationship passion, sexual occurrence, and sexual satisfaction: A dyadic diary analysis. Social Psychological and Personality Science, 3, 224–231. doi:10.1177/1948550611416520.

    Article  Google Scholar 

  • Schumm, W. R., Paff-Bergen, L. A., Hatch, R. C., Obiorah, F. C., Copeland, J. M., Meens, L. D., & Bugaighis, M. A. (1986). Concurrent and discriminant validity of the Kansas Marital Satisfaction Scale. Journal of Marriage and the Family, 48, 381–387. doi:10.2307/352405.

    Article  Google Scholar 

  • Smith, A. M. A., Patrick, K., Heywood, W., Pitts, M. K., Richters, J., Shelley, J. M., & Ryall, R. (2012). Sexual practices and the duration of last heterosexual encounter: Findings from the Australian Longitudinal Study of Health and Relationships. Journal of Sex Research, 49, 487–494. doi:10.1080/00224499.2011.598247.

    Article  PubMed  Google Scholar 

  • Smith, K. B., & Pukall, C. F. (2011). A systematic review of relationship adjustment and sexual satisfaction among women with provoked vestibulodynia. Journal of Sex Research, 48, 166–191. doi:10.1080/00224499.2011.555016.

    Article  PubMed  Google Scholar 

  • So, P. S., Jiang, Y., & Qin, Y. (2008). Touch therapies for pain relief in adults. Cochrane Database of Systematic Reviews,. doi:10.1002/14651858.CD006535.pub2.

    PubMed  Google Scholar 

  • Soklaridis, S., Cartmill, C., & Cassidy, D. (2011). Biographical disruption of injured workers in chronic pain. Disability and Rehabilitation, 33, 2372–2380. doi:10.3109/09638288.2011.573056.

    Article  PubMed  Google Scholar 

  • Sutherland, O. (2012). Qualitative analysis of heterosexual women’s experience of sexual pain and discomfort. Journal of Sex and Marital Therapy, 38, 223–244. doi:10.1080/0092623X.2011.606880.

    Article  PubMed  Google Scholar 

  • Svedhem, C., Eckert, G., & Wijma, B. (2013). Living with genito-pelvic pain/penetration disorder in a heterosexual relationship: An interpretative phenomenological analysis of interviews with eight women. Sexual and Relationship Therapy, 28, 336–349. doi:10.1080/14681994.2013.844785.

    Article  Google Scholar 

  • van Anders, S. M., Edelstein, R. S., Wade, R. M., & Samples-Steele, C. R. (2013). Descriptive experiences and sexual vs. nurturant aspects of cuddling between adult romantic partners. Archives of Sexual Behavior, 42, 553–560. doi:10.1007/s10508-012-0014-8.

    Article  PubMed  Google Scholar 

  • Weiner, L., & Avery-Clark, C. (2014). Sensate focus: Clarifying the Masters and Johnson’s model. Sexual and Relationship Therapy, 29, 307–319. doi:10.1080/14681994.2014.892920.

    Article  Google Scholar 

  • White, G., Ven, F. A. C., & Jantos, M. (1998). Sexual behavior changes with vulvar vestibulitis syndrome. Journal of Reproductive Medicine for the Obstetrician and Gynecologist, 43, 783–789.

    PubMed  Google Scholar 

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Funding

This research was supported by a postdoctoral fellowship awarded to the second author from the Canadian Institutes of Health Research (CIHR) and by grants awarded to the second and fourth author from the CIHR and the Social Sciences and Humanities Research Council.

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Correspondence to Sarah A. Vannier.

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Vannier, S.A., Rosen, N.O., Mackinnon, S.P. et al. Maintaining Affection Despite Pain: Daily Associations Between Physical Affection and Sexual and Relationship Well-Being in Women with Genito-Pelvic Pain. Arch Sex Behav 46, 2021–2031 (2017). https://doi.org/10.1007/s10508-016-0820-5

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Keywords

  • Affection
  • Provoked vestibulodynia
  • Genito-pelvic pain
  • Sexual satisfaction
  • Relationship satisfaction
  • Sexual functioning