Sexual Cues Mediate the Daily Associations Between Interpersonal Goals, Pain, and Well-being in Couples Coping With Vulvodynia

Background Vulvodynia is an idiopathic vulvovaginal pain condition that has significant sexual and relational consequences. Most women with vulvodynia continue to have intercourse, possibly because of a desire to approach positive outcomes (e.g., intimacy) and avoid negative outcomes (e.g., partner disappointment). Purpose This study examined daily associations between approach and avoidance sexual goals and women's pain during intercourse and couples' sexual and relational well-being, as well as the mediating role of sexual cues. Methods Over 8 weeks, on sexual activity days (M = 8.77), women with vulvodynia (N = 101) and their partners reported their sexual goals, attention to sexual cues, sexual function, and relationship satisfaction, and women reported pain during intercourse. Results On days when women and partners held higher approach goals, they attended more to positive sexual cues, and in turn, felt more relationally satisfied, whereas on days when they held higher avoidance sexual goals, partners were more focused on negative sexual cues, and in turn, partners reported lower relationship satisfaction. On days when women reported higher approach goals, they reported less pain, and both they and their partners attended more to positive sexual cues, and in turn, both had higher sexual function, whereas on days when women reported higher avoidance goals, both they and their partners attended more to negative sexual cues, and in turn, women reported greater pain, and both partners reported poorer sexual function. Conclusions Interventions should target cognitive-affective processes during sexual activity as one pathway by which sexual goals impact pain and adjustment.