Sexual Arousal in Women with Superficial Dyspareunia

Abstract

The role of sexual arousal in the etiology and/or maintenance of superficial dyspareunia is still unclear. Lack of sexual arousal may be both the cause and the result of anticipated pain. This study compared genital and subjective sexual responses to visual sexual stimuli of women with dyspareunia and women without sexual complaints. We investigated whether women with dyspareunia were less genitally and subjectively responsive to noncoital (oral sex) as well as coital visual sexual stimuli than women without sexual problems, or whether they exhibited a conditioned anxiety response such that sexual arousal responses were lower only to stimuli that may induce fear of pain (i.e., coitus). A total of 50 women with dyspareunia and 25 women without sexual problems were shown two sexual stimuli, one depicting oral sex and the other one depicting coitus. Genital arousal was assessed as vaginal pulse amplitude using vaginal photoplethysmography. Self-reported ratings of subjective sexual arousal were collected after each erotic stimulus presentation. Women with dyspareunia had comparable levels of genital arousal to two different visual sexual stimuli as women without sexual complaints. Contrary to expectation, there was an indication that women with dyspareunia reacted with higher levels of genital arousal to the explicitly depicted coitus stimulus than controls, whereas controls had higher genital responses to the oral sex stimulus. With respect to subjective sexual arousal, it was found that women with dyspareunia reported less positive feelings in response to both erotic stimuli than controls. We conclude that, with adequate visual sexual stimulation, women with dyspareunia showed equal levels of genital sexual arousal to visual sexual stimuli as women without sexual complaints. Therefore, there was no evidence for impaired genital responsiveness associated with dyspareunia. Also, we found no evidence for a conditioned anxiety reaction in response to exposure to a coitus scene.

Automatic and Deliberate Affective Associations with Sexual Stimuli in Women with Lifelong Vaginismus Before and After Therapist-Aided Exposure Treatment

“…In accordance with earlier research, the current findings show that women with vaginismus also distinguish themselves from controls with regard to their subjective (deliberate) global affective associations with sexual stimuli [30]. These findings underline the important role of ambivalent emotions in response to erotic stimuli in women with various sexual dysfunctions [13,47–49]. The current study in women with vaginismus showed that enhanced levels of more negative affect occurred not only in response to penetration stimuli but also following nonpenetration stimuli.…”

Visual Attention to Erotic Images in Women Reporting Pain with Intercourse

“…The results for physiological sexual arousal in women with dyspareunia are somewhat mixed, with some research suggesting that women with dyspareunia have greater vasocongestion to depictions of coitus compared to healthy controls (Brauer, Laan, & ter Kuile, 2006), and other data showing the opposite pattern (Wouda et al, 1998). Although physiological sexual arousal was not directly measured in this study, the relationship between cognitive distraction and sexual arousal has clear implications for our results.…”

Psychosexual aspects of vulvovaginal pain

“…Research conducted in laboratory settings indicates that there are no significant differences between women with vulvovaginal pain and non afflicted women relative to their physiological level of sexual arousal when exposed to an erotic stimulus, although women with pain tend to report more negative feelings toward the stimulus [13][14][15].…”

“…Specifically, controlled studies have shown that they report significantly less sexual desire, arousal and satisfaction, more difficulty reaching orgasm, as well as lower frequencies of intercourse and more negative attitudes toward sexuality than pain-free controls [12]. Research conducted in laboratory settings indicates that there are no significant differences between women with vulvovaginal pain and non afflicted women relative to their physiological level of sexual arousal when exposed to an erotic stimulus, although women with pain tend to report more negative feelings toward the stimulus [13][14][15].…”

“…Specifically, controlled studies have shown that they report significantly less sexual desire, arousal and satisfaction, more difficulty reaching orgasm, as well as lower frequencies of intercourse and more negative attitudes toward sexuality than pain-free controls [12]. Research conducted in laboratory settings indicates that there are no significant differences between women with vulvovaginal pain and non afflicted women relative to their physiological level of sexual arousal when exposed to an erotic stimulus, although women with pain tend to report more negative feelings toward the stimulus [13][14][15].Both quantitative and qualitative studies show that many women with vulvovaginal pain also report negative changes in their sexual self-esteem and in their body image, such as feeling less sexually desirable, feeling less confident about their sexuality and feeling less feminine than before [16][17][18][19]. Specifically, a study conducted among a community sample of 330 women showed that, in comparison to pain-free controls, women with vulvovaginal pain reported significantly more distress about their body image and a more negative genital self-image.…”