Visual Attention to Erotic Images in Women Reporting Pain with Intercourse

Abstract

The coupling of sex and pain creates an interesting theoretical conundrum of clinical significance: Are women with dyspareunia distracted from sexual stimuli, or are they hypervigilant to sexual stimuli because these stimuli elicit thoughts and expectations of pain? This study measured attention to sexual stimuli in women reporting persistent pain with intercourse, women reporting low sexual desire, and women reporting no sexual problems. Participants viewed a series of erotic images, each containing an object intended to distract from the erotic scene regions, while an eye tracker recorded their eye movements. Women with pain looked for shorter periods of time and fewer times at the sexual scene region than did both women with low sexual desire (p = .024 and p = .018, respectively) and the no-dysfunction control group (p < .001 and p = .003, respectively). Women with pain also looked at the context (nonsexual) scene region significantly more times and for longer periods than did the no-dysfunction control women (p = .013 and p = .042, respectively). Results are interpreted to be potentially supportive of the cognitive distraction hypothesis associated with sexual dysfunction, with an additional component of cognitive avoidance of sexual stimuli for the women reporting sexual pain.

Body Image in Women with Primary and Secondary Provoked Vestibulodynia: A Controlled Study

“…Moreover, a more negative BI during sexual activities was associated with higher pain intensity during intercourse. Women with PVD tend to be hypervigilant about their pain [70] and to focus their attention on nonerotic stimuli [71]. In the present study, women with PVD1 reported more anxiety regarding their body during sexual activities compared with no‐pain controls.…”

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

“…It is possible that when one or both partners of these couples have relatively high AEE, they will feel more conflicted over expressing these emotional preoccupations and, in turn, also more anxious and less able to refocus on the sexual activity at hand—thereby negatively impacting the sexual function of the couple as a whole [54]. This is in accord with the cognitive distraction model of sexual dysfunction [55], which has been found to be relevant to women who suffer from painful intercourse [56]. In an eye‐tracking visual attention study, women with dyspareunia were found to spend less time focusing on erotic aspects of images than a control group of women.…”

Sexual desire, not hypersexuality, is related to neurophysiological responses elicited by sexual images

“…Also, those who are more sexually excitable miss more target stimuli in Go/No-Go tasks (Macapagal, Janssen, Fridberg, Finn, & Heiman, 2011). Finally, women with lower sexual desire fixate more on contextual than sexual parts of erotic scenes than controls (Lykins, Meana, & Minimi, 2011). These attentional effects affected by sexual desire level also are malleable within-person to exogenous testosterone (Van der Made et al, 2009).…”