By Justin Dubé

This post is a summary of our published articles: Dubé, J. P., Bergeron, S., Muise, A., Impett, E. A., & Rosen, N. O. (2017). A comparison of approach and avoidance sexual goals in couples with vulvodynia and community controls. The journal of sexual medicine, 14(11), 1412-1420.

Provoked vestibulodynia (PVD) is the most common cause of pain during sex for premenopausal women. The majority of women with PVD continue to have sex despite their pain, but the dysfunction interferes with their sexual and relational well-being. Prior research from our lab has found the reasons why couples with PVD engage in sex (i.e., their sexual goals) affect their adjustment to the condition [1,2]. Whereas pursuing sex for positive outcomes, such as to show love for a partner (i.e., an approach sexual goal), is linked to couples’ better sexual and relational well-being, engaging in sex to avoid negative outcomes, like disappointing a partner (i.e., an avoidance sexual goal), is linked with less favorable relationship and sexual adjustment for couples with PVD. So, while prior research from our lab suggests approach sexual goals are more adaptive than avoidance sexual goals for couples’ well-being, it’s uncertain whether sexual goals differ in couples coping with PVD.

The aim of the current study was to compare the approach and avoidance sexual goals of women with PVD and their partners to pain free control couples. Because PVD makes sexual intercourse painful and affected women report fears of losing the partner because of the pain, we predicted that women with PVD would engage in intercourse more to avoid negative consequences (avoidance goals) compared to women without pain who might engage in intercourse more to pursue positive outcomes (approach goals).

What we did
We asked 161 couples affected by PVD and 172 unaffected couples to complete measures of approach and avoidance sexual goals. On a scale that ranged from 1 to 7, participants rated the importance of four approach sexual goal items (e.g., “to experience pleasure with my partner”) and five avoidance sexual goals items (e.g., “to prevent my partner from becoming upset”) in motivating their decision to have sex with their partner.

What we found
Women with PVD reported higher avoidance and lower approach sexual goals than control women. Women with PVD also reported higher avoidance and lower approach sexual goals compared to their partners, while there were no differences between partners in the control sample.

What does this mean?
The findings from the current study suggest that women affected by PVD engage in sex for less adaptive motives than control women. It is possible that women with PVD tend to engage in sex for more avoidance reasons than controls because the sexual pain places more strain on the relationship of PVD couples. As a result, women with PVD may be more likely than controls to engage in sex to avoid further stress, conflict, or guilt. Given that these avoidance sexual goals are related to negative sexual and relational outcomes, couples with PVD might consider their reasons for having sex, striving to decrease avoidance goals and increase approach goals for sex.

1. Rosen, N. O., Muise, A., Bergeron, S., Impett, E. A., & Boudreau, G. K. (2015). Approach and avoidance sexual goals in couples with provoked vestibulodynia: Associations with sexual, relational, and psychological well‐being. The journal of sexual medicine, 12(8), 1781-1790.

2. Rosen, N. O., Dewitte, M., Merwin, K., & Bergeron, S. (2017). Interpersonal goals and well-being in couples coping with genito-pelvic pain. Archives of sexual behavior, 46(7), 2007-2019.

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