Fear-Based Reasons For Not Engaging in Sexual Activity During Pregnancy

Posted on Apr 12, 2017

By Jaimie Beveridge

This blog summarizes our recently published paper: Beveridge, J. K., Vannier, S. A., & Rosen, N. O. (2017). Fear-based reasons for not engaging in sexual activity during pregnancy: Associations with sexual and relationship well-being. Journal of Psychosomatic Obstetrics & Gynecology. doi: 10.1080/0167482X.2017.1312334.

TV shows and movies love to joke about having sex during pregnancy – especially about what could happen to the baby. Seth Rogen’s character in Knocked Up is worried about poking his unborn baby in the face, while Sarah Jessica Parker’s character in Sex and the City jokes that that’s where dimples come from.






While these concerns are comical when expressed by fictional characters, they are also concerns that people have in real life. In fact, research shows that about half of women report fears that sexual activity could harm their baby or cause serious complications to their pregnancy (like bleeding, preterm labour, or miscarriage) [1-3]. These fears are found across cultures and may even lead women to stop engaging in sexual activity while pregnant [4-8].

Are these concerns and fears about sex harming the pregnancy warranted? Should women be refraining from sex during pregnancy in order to avoid harm to their pregnancy?

Research tells us that, for low risk pregnancies (pregnancies without complications such as lower genital tract infection or placenta previa), sex is safe and may even have some benefits during pregnancy [9,10]*. This means that, for the majority of women, sex will not harm the pregnancy and so avoiding sex due to fear of harming the pregnancy is not necessary. That’s good news! However, women still report not engaging in sexual activity during pregnancy due to these fears and past research does not tell us is whether women who avoid sex due to fear of harming their pregnancy experience lower sexual and relationship well-being.

This is what we wanted to know. Specifically, we wanted to (1) describe the importance of fears of sexual activity harming the pregnancy in women’s decision not to have sex during pregnancy and (2) examine how these fear-based reasons for not engaging in sexual activity relate to women’s sexual functioning, sexual satisfaction, sexual distress, and relationship satisfaction during pregnancy.

What did we do?

We had 261 women complete an online survey that included validated measures of sexual functioning, sexual satisfaction, sexual distress and relationship satisfaction. We also asked women to think back on times they chose not to engage in sexual activity (defined as genital stimulation, oral sex, vaginal intercourse, and/or anal intercourse) in the last month and rate how important fears of complicating the pregnancy or harming the baby were in this decision. Fears were rated on a scale of 1 (not important at all) to 7 (extremely important) and included concerns about preterm labour, bleeding, infection, and harming or injuring the baby. Women were asked about their own fears as well as their partner’s fears.

What did we find?

  • Overall, we found that 58.6% of women endorsed (rated the fear above 1 [not at all important]) at least one fear as a reason for not engaging in sexual activity in the past month, but women’s average fear scores were low (average = 1.7 out of a possible 7).
  • We also found that women who reported more fear-based reasons for not engaging in sexual activity were more likely to experience greater sexual distress (negative feelings related to their sexuality and/or sexual relationship).
  • We did not find a link between women’s fear-based reasons for not engaging in sexual activity and their sexual functioning, sexual satisfaction, or relationship satisfaction.

What do these findings mean?

Broadly, this research tells us that if you have been pregnant, chances are that you felt at least a little concerned about being sexually active during your pregnancy, but that these concerns did not have a big impact on your overall sexual and romantic relationship.

Overall fear scores were low, and over 40% of women did not report any fear-based reasons. This means that most pregnant women do not rate fears as overly important in their decision not to engage in sexual activity during pregnancy.

When women do experience these fears they may be more likely to feel distressed about their sexual relationship. This includes feelings of guilt, frustration, unhappiness, and inadequacy. It is possible that women who are concerned about sex harming their pregnancy also pay more attention to the sexual changes that are common during pregnancy, such as reduced desire and changes in body image. In turn, this might lead to more distress and worry about their sexual relationship in general.


Taken together, our results suggest that fears of sexual activity harming the pregnancy are not a strong predictor of women’s overall sexual and relationship well-being during pregnancy. As such, interventions that focus specifically on women’s fears of sexual activity may not be necessary for most women, and may not be essential for promoting women’s broader sexual and relationship well-being during pregnancy. Instead, interventions that focus on other areas of women’s sexuality and relationship, such as normalizing changes in women’s sexual functioning or finding alternative and enjoyable sexual positions, may be more valuable. Still, interventions focused on minimizing fears related to sexual activity may help to reduce women’s global feelings of worry and anxiety about their sexual relationship during pregnancy.

* Note: Please talk to your doctor if you have any concerns about having sex while pregnant.


[1] Pauls RN, Occhino JA, Dryfhout VL. Effects of pregnancy on female sexual function and body image: A prospective study. J Sex Med 2008;5:1915-22.

[2] Bartellas E, Crane JMG, Daley M, Bennett KA, Hutchens D. Sexuality and sexual activity in pregnancy. BJOG 2000;107:964-68.

[3] Jamali S, Mosalanejad L. Sexual dysfunction in Iranian pregnant women. Iran J Reprod Med 2013;11:479-86.

[4] Gałązka I, Drosdzol-Cop A, Naworska B, Czajkowska M, Skrzypulec-Plinta V. Changes in the sexual function during pregnancy. J Sex Med 2015;12:445-54.

[5] Erol B, Sanli O, Korkmaz D, Seyhan A, Akman T, Kadioglu A. A cross-sectional study of female sexual function and dysfunction during pregnancy. J Sex Med 2007;4:1381-87.

[6] Orji E, Ogunlola I, Fasubaa O. Sexuality among pregnant women in South West Nigeria. J Obstet and Gynaecol 2002;22:166-68.

[7] Oruç S, Esen A, Laçin S, Adigüzel H, Uyar Y, Koyuncu F. Sexual behaviour during pregnancy. Aust N Z J Obstet Gynaecol 1999;39:48-50.

[8] Eryilmaz G, Ege E, Zincir H. Factors affecting sexual life during pregnancy in eastern Turkey. Gynecol Obstet Invest 2004;57:103-08.

[9] Jones C, Chan C, Farine D. Sex in pregnancy. CMAJ 2011;183:815-18.

[10] Sayle AE, Savitz DA, Thorp Jr JM, Hertz-Picciotto I, Wilcox AJ. Sexual activity during late pregnancy and risk of preterm delivery. Obstet Gynecol 2001;97:283-89.


So you’re applying for your clinical psychology residency…

Posted on Mar 20, 2017

By Kate Rancourt

First things first, take a deep breath. As you’re probably expecting, the process of securing your clinical psychology residency is not a walk in the park. But it’s also not a slog through the swamp of misery. I’d say it’s more like the average day in Canada: moments of sunshine, and moments of cloud-cover…moments of brutal winds, and moments of relative calm. The old “emotional roller coaster” idea works, too. The thing about emotional roller coasters is that they’re not a journey of ONLY unpleasantness, they’re a journey of unpleasantness AND pleasantness

How do I know? I just went through the long and drawn out APPIC Match! And I survived! I’m one week out from matching to a very good training program. Because it might be relevant to how strongly you consider the ino below, I will tell you that I am adult-focused and specializing in health psychology

You’ll get here, too! And to help you along the way, here are some of my reflections on the whole process. But before you start reading my words of wisdom, I want you to really focus on one thing that I wish someone had said to me before it all started

There is no right or wrong way to go through this process. YOU DO YOU.

Let this by your mantra


The biggest thing I learned about this phase is that it’s important to carefully weigh your desire to “get out and go anywhere” against your desire to have a residency program that you really want. This decision has repercussions for the rest of the process! Are you very much a generalist? Would you be happy with a wide array of training opportunities? Are you looking to specialize in a particular area, so only certain programs will appropriately set you up for the future you want? I fell into the latter category: I knew I would only be happy if I had a program that allowed me to specialize in health psychology. I also decided that I wasn’t going to apply to a program that felt like a mediocre fit (e.g., not the training model I wanted, heavy emphasis on research). Together, this meant that I put out fewer applications than some other applicants (FYI: 8 applications). When my applications went in, I felt confident because I had a refined list! In hindsight, I don’t think I really appreciated what it could mean moving forward. What it meant for me: I received fewer interviews (4 in total) relative to those who put out more applications, and I found this quite discouraging because I only applied to sites that I really thought were going to be a good fit. Also, only having four interviews put A LOT of pressure on doing those interviews well…anxiety!!!

Would I do it differently if I had a do-over? I’m not sure because everything worked out for me in the end. There were perks to only having 4 interviews: travel was less exhausting, I was away from home for a shorter period of time, it cost less money, and I was able to space out interviews more. But that pressure was a big con. So I think if I were to do it again, I’d probably apply to a few more.


This part of the process really wasn’t that bad in my opinion – kinda like the many scholarships you’ve probably applied for in the past ;

Standard advice applies:

Preparing your CV takes a looooong time!

  • Try to find examples of applications from former applicants, but take a stab at writing your essays before you look at theirs.
  • Definitely get a few people to read over your essays!
  • See if you can find an internship buddy to share info and resources with during this part.
  • Write one really good cover letter that you have a few people proof read, and then tweak it.

Prepare yourself from an emotional roller coaster. Notifications of interviews trickle in all day long. I didn’t hear from some sites until close to 5pm. And the notifications can come in any combination: bad news front-loaded and good news back-loaded, a nice balance, or good news front-loaded and bad news at the end of the day (that was more the case for me).

Do what you gotta do to get through it. Some people wanted to sit by their email and constantly hit refresh, others decided to try and distract themselves, and some, like me, fell somewhere in the middle. I definitely went to the gym this day, and was glad that I did!!! And then I took the night off and ordered take-out and watched Netflix with my hubby in PJs. Exactly what I needed. You do you.


This part was tough for me. I found it hard to work on my research because I was so preoccupied by the big task of interviews on the horizon! But I know many other people who were able to put it out of their mind for most of December. Again, it’s figuring out what works for you and being okay with it. I did written prep in December, and then put it away over the holidays and saved oral prep for January. In December, I met a few times with my internship buddies to brainstorm answers and discuss cases, etc. Having buddies was soooooo important to me at this stage! In January, I did mock interviews with my husband where he had my written prep document and just asked me random questions from there. I think my process worked well for me. One thing I learned was that small chunks of prep was better for me than cramming. In the days leading up to my first interview, I definitely found it hard to know what to do – I felt like I had plateaued in terms of prep, and so I felt like I was twiddling my thumbs because I was not in a mindsight to be able to work on my dissertation…


You’ve probably heard it before, but I felt interviews were a mix of stress/anxiety, excitement, and exhaustion. It was tough being on the road, but also exciting to get out of the hotel room and see the sights, dream of life in a new city, and meet new people. I really loved some of my interviews and had fun doing them. I definitely got to a point where I just couldn’t prep anymore, as I think many applicants do! And I also got to a point where I desperately wanted to be home, as I think everyone does…

One point I’d like to make about interviews that I wish I had known: In my experience, the interviews are all very different. Some sites take a very standardized interview approach, whereas others are more laid-back. Some sites, the standardized approach is comfortable, and others it feels stiff and impersonal. So for some interviews I felt really relaxed, and for some I felt more stressed and anxious. I suppose it kinda depends on what style suits you! Just prepare for the experience that you may have interviews where you feel like you didn’t win them over, or you feel like they didn’t want to get to know you and that this might actually reflect a standardized interviewing process rather than a bad interview. The result was that I found it tough to decide on my rankings when the interviews were so different because it made some attractive sites less attractive (even though they were still great on paper).


The nerves about match day began a few days before for me. I did not sleep well the night before match. The major pro about match day is that it’s much shorter than interview notification day: You find out in the morning, but the waiting is super stressful! I took the morning off and went bouldering because it was both physical exertion and mental distraction. But again, you do you.



This was by far the hardest part of the APPIC match process for me. I can’t say that everyone struggles with this aspect, but I’d hazard a guess to say that the vast majority do. And I think this is an important thing to talk about in training programs, and among your peers and your family and friends. Remember: APPIC is about a 6-month long journey, with multiple points of stress, but also multiple points of excitement and opportunity.

It was a challenge for me to go through the rollercoaster of emotions. This was my grad school experience that most taught me about the importance of self-care and coping. I had become very sure of myself through 5 years of grad school, and I found myself back in a place of insecurity and anxiety, which was confusing and hard. I had a friend and fellow applicant put it to me this way: APPIC is taking a bunch of brilliant, super-keeners who are at the end of a PhD, when they’re tired, stressed, and uncertain about the future, and putting them through a looooong, evaluative process. I found this really helped to contextualize the range of emotions I was feeling!

The other thing I want you to know about this piece is as follows: Please don’t listen to anyone who tells you how you should be feeling, or what you should be doing to get through it. Feel whatever you need to feel – I guarantee you it’s one of many very normal reactions to this stressful time! It’s okay to be super excited and not feel too much anxiety! It’s also okay to be discouraged by bad news – you don’t need to “keep your chin up.” Just try to find some ways to cope with it that allow you to keep going. For me, that was friends and family, exercise, and music and art.


Give some thought to how you are going to spend the Christmas holidays! What will be best for you? I spent 3 weeks away from home, which was nice in many ways, but it also meant that I was already tired of travelling before I even started the interview circuit. If I did it again, I personally would have spent more time in my own space to help me mellow as I prepared for interviews.


I can’t speak for everyone, but I’m still feeling nervous even though the match is over! It’s only one week out, so that might have something to do with it, but keep in mind that there’s a lot of change on the horizon once you match to a program! But that also comes with opportunity to start dreaming and getting excited about a new year ahead of you.





Sexual Distress and Sexual Problems during Pregnancy

Posted on Mar 12, 2017

This is a summary of our recently published paper: Vannier, S.A., & Rosen, N. O. (2017). Sexual Distress and Sexual Problems during Pregnancy: Associations with Sexual and Relationship Satisfaction. Journal of Sexual Medicine. doi: 10.1016/j.jsxm.2016.12.239

By Sarah Vannier

This study was part of our research program aimed at identifying ways to improve women’s and couples’ sexual and relationship well-being during pregnancy and the transition to parenthood (Read more here, here, and here). We know that sexual problems are very common during pregnancy. For example, 31% to 58% of pregnant women say that they feel less sexual desire, have more trouble feeling turned on, lubricating, or having an orgasm, and are feeling more genital or pelvic pain [1-4]. Similarly, a study in 2007 surveyed 589 pregnant women and found that a whopping 63% said they were dissatisfied with their sex life [5]. As sexual and relationship satisfaction are closely related, pregnant women who experience sexual problems may be at a higher risk for relationship problems during pregnancy and during the early stages of parenthood.

The main goal of this study was to look at women’s experiences of sexual distress during pregnancy. Sexual distress is defined as negative emotions about your sex life. These negative emotions include guilt, frustration, stress, worry, anger, and embarrassment.

In studies with non-pregnant women, women with more sexual distress tend to be less satisfied with their sexual relationship [6, 7]. Further, women with low sexual desire and high sexual distress were more likely to describe themselves as unhappy with their relationship as compared to women with low desire but no sexual distress [7]. Based on this, we expected that pregnant women who reported sexual distress would be at a higher risk for sexual and relationship dissatisfaction. We also expected that this would be particularly true for women who also reported sexual problems.

What did we do?

We recruited pregnant women online from August 2015 to March 2016 through Facebook, classified ads, word of mouth, and Reddit as part of a larger study on sexuality in pregnancy. To participate women had to be over the age of 18, in a romantic relationship, living in the United States or Canada, and fluent in English. Women completed online questionnaires measuring their sexual functioning, sexual distress, sexual satisfaction, and relationship satisfaction. They also answered questions about the demographics (e.g., age, education, income) and characteristics of pregnancy (e.g., how many weeks pregnant they were).


What did we find?

We looked at the data from 261 women. Women ranged in age from 19 to 41 years old (average = 28) and were between 4 and 40 weeks pregnant (average = 23). The average relationship length was just under seven years.

  • Overall, 42% of women reported sexual distress.
  • Among sexually active women (230 women):
    • 36% reported sexual problems.
    • 26% reported sexual distress and sexual problems.
    • 14% reported sexual distress but not sexual problems.
  • Women who reported sexual distress, sexual problems, or both, also reported lower sexual and relationship satisfaction compared to pregnant women with lower sexual distress and fewer sexual problems.

What does it mean?

The main take-home message from this study is that sexual distress is common during pregnancy and associated with lower sexual and relationship satisfaction. There are several possible reasons why many pregnant women experiencing sexual distress. In addition to an increase in sexual problems, many pregnant women say that they experience changes in their body image. In non-pregnant women, negative changes in body image have been linked with feelings of sexual distress. Some pregnant women may also find it difficult to reconciling the changing sexual and maternal parts of their self-identity. For example, thinking of themselves as both a mother and a sexual person. This might translate to feelings of guilt, frustration, worry, and embarrassment about sexuality, and might be linked with lower reduced sexual and relationship satisfaction, even in the absence of sexual problems.

We also found that sexual problems or distress alone may be enough to have a negative impact on women’s broader sexual and relationship well-being. It is possible that pregnant women who experience problems or distress are more likely to avoid sexual intimacy, and in non-pregnant samples this type of avoidance is linked with poorer sexual and relationship satisfaction [8,9].

Overall, this study suggests that there is a need for education and interventions aimed at minimizing sexual distress alone or with sexual problems among pregnant women. We encourage health care providers to ask pregnant women about feelings of sexual distress regardless of their level of sexual functioning. Pregnant women may benefit from conversations in which their health care providers normalize the discussion of sexuality in the context of their broader well-being. Further, sex therapy that incorporates cognitive-behavioral techniques can reduce sexual distress among women with sexual dysfunction [10] and may also be valuable for women experiencing sexual distress or problems during pregnancy.

What is next?

As with all research it is important to consider the limitations of this study. Our measure of sexual problems could only be scored for women who had engaged in sexual activity in the past four weeks. This means that women who were not sexually active were left out of our main analyses. Our sample was mostly heterosexual, married, and in female-male relationships, which limits our ability to generalize to pregnant women more broadly. The data were cross-sectional, which means we only collected data at one time-point. This means that we cannot make conclusions about the directionality of associations between variables. For example, does sexual distress lead to lower sexual satisfaction, or are women with lower sexual satisfaction increase the risk of feeling sexual distress? Finally, we surveyed only pregnant women, but obviously sexual and romantic relationships are interpersonal and each partner affects the other person’s experience. The way a partner responds to sexual changes and distress during pregnancy may contribute to women’s experiences, and vice versa.

Our future plans include longitudinal research so we can look at the associations between distress and sexual and relationship satisfaction over time, and the links between sexual distress, sexual problems, and sexual and relationship satisfaction from pregnancy to the postpartum. We are also currently recruiting for a study of couples going through the transition to parenthood which will let us look at how one partner’s experience of sexual problems and sexual distress affects the other partner’s sexual and relationship well-being. Find out more about this study here.


  • [1]  Bartellas E, Crane JMG, Daley M, Bennett KA, Hutchens D. Sexuality and sexual activity in pregnancy. Br J Obstet Gynaecol. 2000;107: 964-68.
  • [2] Erenel AS, Eroglu K, Vural G, Dilbaz B. A pilot study: In what ways do women in Turkey experience a change in their sexuality during pregnancy? Sex Disabil. 2011;29: 207-16.
  • [3] Glowacka M, Rosen N, Chorney J, Snelgrove−Clarke E, George RB. Prevalence and predictors of genito‐pelvic pain in pregnancy and postpartum: The prospective impact of fear avoidance. J Sex Med. 2014;11: 3021-34.
  • [4] Pauleta JR, Pereira NM, Graça LM. Sexuality during pregnancy. J Sex Med. 2010;7: 136-42.
  • [5] Erol B, Sanli O, Korkmaz D, Seyhan A, Akman T, Kadioglu A. A cross-sectional study of female sexual function and dysfunction during pregnancy. J Sex Med. 2007;4: 1381-87.
  • [6] Stephenson KR, Meston CM. When are sexual difficulties distressing for women? The selective protective value of intimate relationships. J Sex Med. 2010;7: 3683-94.
  • [7] Rosen RC, Shifren JL, Monz BU, Odom DM, Russo PA, Johannes CB. Correlates of sexually related personal distress in women with low sexual desire. J Sex Med. 2009;6: 1549-60.
  • [8] Stephenson KR, Meston CM. Differentiating components of sexual well‐being in women: Are sexual satisfaction and sexual distress independent constructs? J Sex Med. 2010;7: 2458-68.
  • [9] Impett EA, Peplau LA, Gable SL. Approach and avoidance sexual motives: Implications for personal and interpersonal well-being. Pers Relationship. 2005;12: 465-82.
  • [10] Rosen NO, Muise A, Bergeron S, Impett EA, Boudreau GK. Approach and avoidance sexual goals in couples with Provoked Vestibulodynia: Associations with sexual, relational, and psychological well-being. J Sex Med. 2015;12: 1781-90.


Let’s talk about sex baby…

Posted on Mar 3, 2017

Image: Shutterstock/Alina Cardiae Photography

By: Kat Merwin

Do you ever communicate with your partner during sex? Do you let them know when you’re enjoying something? Or when you’re not? Then this article is for you!

Do you shudder at the very idea of attempting “dirty talk” during sex? Then this article is still for you!

Are you looking to ‘spice things up’ in the bedroom? Guess what –this article is for you!

It can be difficult to talk about sex –even with the person you’re having sex with! Talking about sex can make you feel vulnerable, and research has shown that people fear being misunderstood, or even rejected, by their partner when it comes to talking about sex [1]. Despite how scary it might be, discussing sexual topics with your partner is important and very worthwhile! When people talk about their sexual likes (and dislikes) with their partner, they experience greater sexual and relationship satisfaction [1-6]. It may be especially important to talk about sex with your partner if you’re in a long-term relationship; couples often experience declines in sexual satisfaction and desire over time [7].

While most research to date has examined the kinds of sexual discussions people have outside of sexual activity, it has become clear that the kinds of sexual talk people engage in during sex are also quite important [8]. In fact, when people communicate more with their partner about their sexual pleasure during sex –and when a person perceives that their partner is communicating more about sexual pleasure during sex—they experience greater sexual satisfaction [9, 10].

But what are couples talking about during sexual activity?

Are they having in-depth political debates? Probably not… unless that’s what turns you or your partner on –in which case, debate away!

Are they talking about their (or their partner’s) sexual pleasure? Probably!

A recent study actually examined the different types of sexual talk that people engage in during sexual activity, and found that there are 2 main types of sexual talk [8]. Note: the examples provided above are not an exhaustive list. The actual phrases that people say to their partner may differ depending on sexual orientation, gender identity, or personal preferences.

Mutualistic Talk: ‘other-focused’ sexual talk that relates to sharing the sexual experience with your partner.

Mutualistic talk includes:

Giving your partner positive feedback (e.g., “That feels so good!” or “You taste so good”)

Giving instructional statements (e.g., “Go harder/faster/slower” or “Go down on me”)

Statements of intimacy (e.g., “I love you” or “I feel so close to you”)

Talking about sexual fantasies (e.g., “Let’s pretend….” or “I’m imagining that people are watching us fuck”


Individualistic Talk: ‘self-focused’ sexual talk that relates to your own sexual experience and pleasure.

Individualistic talk includes:

Exclamations of excitement or pleasure (e.g., “Yes/yeah!” or “Oh god!”)

Statements that are sexually dominant (e.g., “Show me your pussy/cock”)

Statements that are sexually submissive (or inviting your partner to be sexually dominant) (e.g., “I’m all yours” or “Let me be your dirty slut”)

Messages of sexual ownership (e.g., “You’re mine now” or “Whose pussy/cock is this?”)

Both mutualistic and individualistic talk were found to be associated with greater sexual satisfaction —at least for the person doing the talking8 (research hasn’t examined whether the same holds for the person hearing the sexual talk).

Don’t use any of these types of sexual talk during sex, but want to?

Awesome! Maybe start small, such as exclamations of excitement/pleasure or telling your partner when you like what they’re doing. (After all, everyone likes to hear when they’re doing a good job at pleasing their partner!)

Figure out what terminology you want to use. Does ‘vagina’ sound too clinical to you? Try an alternative, such as ‘pussy.’ Do you find the word ‘cock’ sexy, but the word ‘dick’ is a huge turn-off? Share this with your partner! Once you know the words you’re comfortable saying (or hearing) that will make it easier to start using some dirty talk during sex with your partner!

Do you already use some of those types of sexual talk with your partner(s)?

Awesome! Maybe try out some different types of sexual talk (if you and your partner are comfortable with it) or just keep doing what you’re doing!

Final Tip

(insert ‘that’s what she said’ joke here)

Try not to not take it too seriously –have fun with it!




[1] Rehman, U. S., Rellini, A. H., & Fallis, E. (2011). The importance of sexual self-disclosure to sexual satisfaction and functioning in committed relationships. Journal of Sexual Medicine, 8, 3108-3115. doi: 10.1111/j.1743-6109.2011.02439.x

[2] Byers, S. E. (2011). Beyond the birds and the bees and was it good for you?: Thirty years of research on sexual communication. Canadian Psychology, 52, 20-28. doi: 10.11037/a0022048

[3] Byers, S. E., & Demmons, S. (1999). Sexual satisfaction and sexual self-disclosure within dating relationships. The Journal of Sex Research, 36, 180-189. doi: 10.1080/00224499909551983

[4] Coffelt, T. A., & Hess, J. A. (2014). Sexual disclosures: Connections to relational satisfaction and closeness. Journal of Sex & Marital Therapy, 40, 577-591. doi:10.1080/0092623X.2013.811449

[5] Greene, K., & Faulkner, S. (2005). Gender, belief in the sexual double standard, and sexual talk in heterosexual dating relationships. Sex Roles, 53, 239-251. doi: 10.1007/s11199-005-5682-6

[6] MacNeil, S., & Byers, S. E. (2009). Roles of sexual self-disclosure in the sexual satisfaction of long-term heterosexual couples. The Journal of Sex Research, 46, 3-14. doi:10.1080/00224490802398399

[7] Klusmann, D. (2002). Sexual motivation and the duration of partnership. Archives of Sexual Behaviour, 31, 275-287. doi: 10.1023/A:1015205020769

[8] Jonason, P. K., Betteridge, G. L., & Kneebone, I. I. (2016). An examination of the nature of erotic talk. Archives of Sexual Behaviour, 45, 21-31. doi: 10.1007/s10508-015-0585-2

[9] Babin, E. A. (2012). An examination of predictors of nonverbal and verbal communication of pleasure during sex and sexual satisfaction. Journal of Social and Personal Relationships, 30, 270-292. doi: 10.1177/0265407512454523

[10] Brogan, S. M., Fiore, A., & Wrench, J. S. (2009). Understanding the psychometric properties of the sexual communication style scale. Human Communication, 12, 421-445. Retrieved from

New Parents: How empathy for your partner can be beneficial for your relationship post-baby

Posted on Nov 18, 2016


This is a summary of our recently published paper: Rosen, Mooney,  & Muise, (2016). Dyadic Empathy Predicts Sexual and Relationship Well-Being in Couples Transitioning to Parenthood. Journal of Sex & Marital Therapy. doi: 10.1080/0092623X.2016.1208698

By Kayla Mooney

Having a baby is often an exciting time for a couple; however, the transition to parenthood can also bring new emotions and stressors that a couple has never faced before. New parents are transitioning from being just partners, to now being partners and parents. You may notice that you start to view each other differently. Your stress levels are higher, you’re sleep-deprived, and there’s less time to spend together as a couple. Some prior research has shown that this transition may also lead to:

  • Increased conflict within your relationship and lower overall satisfaction with your relationship.
  • Decreased sexual desire, frequency of sexual activity, and lower sexual satisfaction.

We don’t want to alarm you, though: not all couples experience these declines. In fact, approximately 1/3 to 1/2 of couples don’t see a decline in their relationship satisfaction, and some couples even report increases in their relationship satisfaction when becoming parents! But, if you do notice some of these changes, rest assured that you are not alone. New research has shown that aspects of new parents’ personality may help protect against some of these changes, and may even help improve the adjustment to new parenthood!

Recent research by Dr. Natalie Rosen and colleagues suggests that one important key to protecting your romantic and sexual relationship post-baby is to express empathy towards your romantic partner. In this context, empathy refers to your ability to understand your partner’s point of view, and feel compassion as a result of your partner’s experiences. In Dr. Rosen’s study, the researchers found that greater empathy can be beneficial for both you and your partner during the transition to parenthood.

Here’s a brief summary of what the study found:

  • When women and men reported higher empathy, they were also more satisfied with their sexual and romantic relationships.
  • Reporting higher empathy was not only beneficial for the self, but also for one’s partner: women and men who reported higher empathy also had partners who were more satisfied with their sexual and romantic relationships.
  • When women demonstrated higher empathy, they also tended to experience higher sexual desire.
  • One surprising, seemingly contradictory finding, was that women with more empathic partners reported lower sexual desire. It’s possible that this is because women who experience lower desire actually elicit more empathy from their partners (in other words, it’s not that empathy leads to lower desire, but the other way around).

Showing more concern for your partner, and trying to view things from their point of view, may help you talk about your sexual relationship more openly, which can help improve your own and your partner’s satisfaction with both your sex life and relationship. Similarly, when partners are more empathic it can help you both feel that you’re facing parenthood together as a unit – this not only helps you cope with the novel stressors that we talked about earlier (like sleep deprivation), but can help improve your satisfaction with your relationship!

Even though partner empathy was linked to lower sexual desire in mothers, this doesn’t mean you should be less empathic as a partner. It is also possible that when new mothers experience lower sexual desire their partners are more likely to respond with empathy. Because the researchers did not follow couples over time it is not possible to determine whether empathy leads to lower desire or if lower desire elicits greater empathy. And, as the study showed, empathy can be very beneficial for your relationship and sex life, so this one finding should be interpreted with caution until more research is done on the topic.

To read more about this study take a look at some recent media coverage by the CBC.

Image credit: Flickr user PedroCancion



Practice Makes Passable: Practical Advice for GRE Prep.

Posted on Nov 14, 2016


By Justin Dubé

People will tell you there is no way to study for the GRE. They are wrong. The GRE is a puzzle and, like any puzzle, it can be solved. Although there are likely many ways to prepare for the test, I found practicing the GRE (over and over, multiplied by 5, or 6) to be very helpful. Below, I will share some practice tips and other strategies that helped me tackle the test.

homerThe GRE prep course I took recommended writing a full practice test before studying. The experience was a bit alarming (my score was dismal), but it helped me establish a baseline score and identify my strengths and weaknesses. For example, after writing the test with no prep, I discovered each math formula I had learned between grades 5 and 12 had been replaced with Simpsons quotes.

Learning my weaknesses helped to transform an ambiguous problem (i.e., how to get an acceptable GRE score) into a concrete problem (e.g., relearn how to calculate the area of a circle, learn how to calculate how much debt you will accrue over the course of grad school, etc…). Also, establishing a baseline of my abilities revealed the discrepancy between where I was (grade 4 level math) and where I wanted to be (getting an acceptable quant score) which motivated me to practice. If you’re anything  like me (or the people in this study: Regulating goal pursuit through Mental Contrasting with Implementation Intentions) writing a GRE practice test before studying will motivate you to improve your weak areas and spur you to practice more.

Another GRE prep tip that I found useful was to schedule my practice tests. There are several benefits to doing this. First, you will (hopefully) actually write the practice tests. Second, knowing when you will practice will allow you to block the 4 hours (!!!) needed to complete the test. Regarding interval of practice, I found writing one test per week until the exam worked well for me; whether this will generalize to your situation will depend on how much time you have to prepare and how many practice tests you have access to. Practicing once a week gave me enough time to recover from writing, review the tests, and then work on my weaknesses. Other GRE prep strategies and pieces of advice which I found helpful were the following:

  • Schedule your actual test! You may be inclined to postpone scheduling your test until after you feel you’re prepared to write. However, I found scheduling my test motivated me to practice and helped me remember that “this too shall pass”.

  • Practice the whole test, in order. This means even practicing the analytical writing portion, at the beginning. Doing so will help you get into the flow of the test and build your stamina. If you have a bunch of practice tests, but no writing prompts, ETS has a bank of topics here:

  • Practice under timed conditions. It may be tempting to give yourself a little more time, or take an extra-long break between sections, but replicating the timed testing conditions will give you a more accurate gauge of your performance.

  • Practice writing at the same time of day as your scheduled test. This is particularly helpful if, for example, you’re a night owl who will be writing a morning test. Two weeks before I wrote, I started setting my alarm to the time I would need to wake on test day. It was terrible, but helpful.

In the end, remember to keep it in perspective! The GRE is one small portion of your application. In many cases, your score is nothing more than a screening tool, not a guarantee of admission into a program. Remember this and you may feel a little less stressed when preparing for, and writing, the test. Like many others, I felt my test didn’t go as well as it could have and was considering writing again. Fortunately, I had a mentor who was able to redirect my focus. Instead of re-writing the test, I spent time strengthening my application, which I believe served me well. And really, who wants to write the GRE more than once? In some cases, good enough is good enough.

Good Luck!



Oettingen, G., Wittchen, M., & Gollwitzer, P. (2013). Regulating goal pursuit through mental contrasting with implementation intentions. In Taylor and Francis.

Image credit:

Flickr user ray_lac

Why I love being a scientist-practitioner…maybe you will too… [A blog post for those considering a PhD in Clinical Psychology]

Posted on Oct 12, 2016

By Serena Corsini-Munt


Image credit: flickr user CollegeDegrees360

So you’re thinking about applying for a PhD in Clinical Psychology? This might mean that you are pursuing a career as a practicing psychologist. You may want to be trained to provide psychotherapy to those in need. You are empathic and the idea of helping others seems like a rewarding path. Or maybe, you have found a professor you greatly admire and want to pursue a similar career path, or you always knew a life of academia was for you. You have the research bug, want to engage in knowledge dissemination and the idea of teaching appeals to you. All are good.

One of the things I like about having completed a PhD in Clinical Psychology? There are not too many PhDs like it. A PhD in Clinical Psychology, like those in Counselling Psychology and Neuropsychology, is a professional PhD. When complete, you will be able to apply for membership in a professional order or college, and hold the title of psychologist. You might pursue academic life, you might practice psychology, or both! All have the potential to be fulfilling and worthy pursuits. But to get there, you’re going to have to do some research. Reframed: you’re going to get to do some research.

Unfortunately, some people shy away from pursuing a PhD in Clinical Psychology because they do not find research exciting or because they want training that will get them to work with people in a clinical setting more quickly. I worry that they have foreclosed too soon. The reactions range from being intimidated by research, viewing research as a means to an end, or resentful, as though research is an obstacle to becoming a psychologist. Why do psychologists need to know how to conduct research? Because learning to conduct research during your PhD may make you a better clinician.

The scientist-practitioner model is often part of a program’s description. It is often thought of as an integral component of contributing to psychology’s reputation for being science-directed, but it represents something more. The scientist-practitioner model attempts to capture the two roles of the psychologist and speak to the importance of training in each domain. Tenets of the model include:

  • Education in clinical psychology should give equal billing to research training and clinical skills.
  • Assessment and treatment should follow empirically-based protocols and clinical decisions should be informed by empirical findings.
  • Just as the researcher contributes to practice with empirical evidence, the clinician is expected to contribute to research with practice-based evidence.

I’m of the opinion that there is a reciprocal and beneficial relationship between science and practice in which each gives the other purpose. We cannot practice responsibly without knowing the rationale behind our interventions, nor without appreciating their potential effect. Science contributes to better understanding clinical populations and helps us better understand those that enter our clinical practice. Knowing which treatments might benefit which patients plays a HUGELY important role in shaping how clinicians help people. And clinicians have direct access to the needs of their patients so that research might target clinically-relevant outcomes.

Are you preparing for PhD applications, or thinking about applying to a PhD program in Clinical Psychology?

Quick Check List

  • Are you pursuing an honours or a research project?
  • Are you participating in pre-clinical experiences, such as volunteering in clinical care settings, or working for talk- and crisis-lines?
  • Are you getting experience working with different areas to broaden your exposure to topics?
  • Are you working for different professors who will be able to provide letters of recommendation?
  • Are you working towards the best possible grades in your classes?
  • If applying to English-speaking universities, are you preparing for your General GREs and Psych GREs?
  • Have you taken note of the application requirements for programs of interest?
  • Are you talking to graduate students and professors about what grad school is like?
  • Have you reviewed the steps to licensure as a psychologist in your geographical area?

So, if you are considering a PhD in Clinical Psychology, I hope you’ll embrace research if practice is your main interest, and I hope you’ll draw from practice if research is your focus. Take your time to find an area of research that is personally motivating and ignites your passion for both research and practice.

Baker, D. B., & Benjamin, L. T. (2000). The affirmation of the scientists-practitioner: A look back at Boulder. American Psychologist, 55, 241–247. doi:10.1037/0003-066X.55.2.241.

Jones, J., & Mehr, S. (2007). Foundations and assumptions of the scientist–practitioner model. American Behavioral Scientist, 50, 766–771. doi:10.1177/0002764206296454.

Navab, A., Koegel, R., Dowdy, E., & Vernon, T. (2016). Ethical considerations in the application of the scientist-practitioner model for psychologists conducting intervention research. Journal of Contemporary Psychotherapy, 46, 79-87. DOI 10.1007/s10879-015-9314-3

Petersen, C. A. (2007). A historical look at psychology and the scientist–practitioner model. American Behavioral Scientist, 50, 758–765. doi:10.1177/0002764206296453.

Shapiro, D. S. (2002). Renewing the scientist–practitioner model. Psychologist, 55, 247–248.

Diagnosing Sexual Dysfunction

Posted on Oct 3, 2016

Diagnosing Sexual Dysfunction

By Maria Glowacka

Are you wondering if your sexual problem is a sexual dysfunction?

First, if you’re wondering whether you should go talk to a health professional about a sexual problem you have been experiencing, the answer is YES if it is distressing to you and/or your partner. A health professional will likely ask you some questions about the problem and whether it developed in the context of a health condition or taking certain medications. For a sexual problem to be considered a sexual dysfunction, it must meet the diagnostic criteria outlined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; [1]). The DSM-5 has classifications for seven sexual dysfunctions (described below). To be diagnosed with a sexual dysfunction, the symptoms must be present for at least six months, cause you significant distress, and cannot be caused exclusively by a non-sexual mental disorder, significant relationship distress, medical illness, or medication.

Male Sexual Dysfunction

The DSM-5 provides diagnostic criteria for four sexual dysfunctions that are specific to biological males (i.e., individuals who are born with male genitalia). Delayed Ejaculation is delayed, infrequent, or absent ejaculation in at least 75% of partnered sexual activity occasions. In the previous version of the DSM (DSM-IV-TR; [2]), this sexual dysfunction was referred to as Male Orgasmic Disorder. According to the current DSM, Erectile Disorder is diagnosed when a male has (1) difficulty getting an erection, (2) difficulty maintaining an erection, or (3) a decrease in how rigid the erection is during 75 to 100% of sexual activity encounters. Male Hypoactive Sexual Desire Disorder is a lack of or recurrent decrease in sexual thoughts, fantasies, and desire for sexual activity. It is the responsibility of the diagnosing clinician to determine that desire is not only perceived as low in comparison to the desire of one’s partner (which would be a desire discrepancy between partners and maybe not a sexual dysfunction). Premature (Early) Ejaculation is diagnosed when ejaculation occurs within one minute following vaginal penetration and before the person wishes it on at least 75% of partnered sexual activity occasions. It is important to note that this diagnosis is applicable to men who engage in non-vaginal sexual activity, but unfortunately the specific duration criteria remain unknown.

Female Sexual Dysfunction

There are three sexual dysfunctions in the DSM 5 that are specific to biological females (i.e., individuals who are born with female genitalia). Female Orgasmic Disorder is a delay in, infrequency of, or absence of orgasm, or a reduced intensity of orgasmic sensations during 75 to 100% of sexual activity encounters. Since there is lots of variation in the type or intensity of stimulation that triggers orgasm, clinicians are left to judge if a female’s ability to orgasm is less than expected for her age, sexual experience, and stimulation received. Female Sexual Interest/Arousal Disorder is absent or reduced sexual interest/arousal. This is determined by meeting three or more of the following criteria: (1) reduced/absent interest in sexual activity, (2) reduced/absent sexual thoughts/fantasies, (3) reduced/no initiations of sexual activity or not responding to partner initiations, (4) reduced/absent excitement or pleasure during 75 to 100% of sexual activity events, (5) reduced/absent interest/arousal in the context of any sexual cues, or (6) reduced/absent genital or non-genital sensations during 75 to 100% of sexual activity events. As with Male Hypoactive Sexual Desire Disorder, these symptoms must not only be a desire discrepancy between partners. The diagnosis of Female Sexual Interest/Arousal Disorder is a combination of Female Hypoactive Desire Disorder and Female Arousal Disorder from the DSM-IV-TR. Finally, the DSM 5 (American Psychiatric Association, 2013) characterizes Genito-Pelvic Pain/Penetration Disorder as constant or repeated difficulties with (1) vaginal penetration during intercourse, (2) vaginal or pelvic pain during penetration, (3) significant fear/anxiety about vaginal or pelvic pain, or (4) tensing of pelvic floor muscles during penetration attempts. Genito-Pelvic Pain/Penetration Disorder is a combination of the diagnostic criteria of Dyspareunia and Vaginismus in the DSM-IV-TR. Male genital pain has been removed from the current version of the DSM because of insufficient research, even though there is growing evidence of men experiencing pain during erection, ejaculation, and receptive anal intercourse [3].

Each of the sexual dysfunctions could be lifelong (present since becoming sexually active) or acquired (developed overtime), generalized (present in a variety of situations) or situational (only present with certain stimulation, situations, or partners), and clinicians could specify whether distress over symptoms is mild, moderate, or severe. Note that not everyone agrees on the diagnostic criteria for all of these sexual dysfunctions. There is a variety of ways that people can experience a distressing sexual problem. That being said, you might find yourself suffering from a sexual problem that doesn’t quite meet the criteria above to be considered a “sexual dysfunction”. If you’re distressed by this problem and/or it’s negatively impacting your relationship, you should go talk to a health professional. They can still help you out or point you in the right direction.


[1] American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association.

[2] American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: American Psychiatric Association.

[3] Bergeron, S., Rosen, N. O., & Pukall, C. P. (2014). Genital pain in women and men: It can hurt more than your sex life. In Y. M. Binik & K. S. K. Hall (Eds.), Principles and practice of sex therapy, fifth edition (pp. 159-176). New York: Guilford Press.



A New Baby in the Bedroom: Frequency and Severity of Postpartum Sexual Concerns and Their Associations With Relationship Satisfaction in New Parent Couples

Posted on Sep 26, 2016

A couple in bed, with just their feet showing and white sheets

By Hera Schlagintweit

*Note: This is a summary of our recently published paper: Schlagintweit, H. E., Bailey, K., & Rosen, N. O. (2016). A New Baby in the Bedroom: Frequency and Severity of Postpartum Sexual Concerns and Their Associations With Relationship Satisfaction in New Parent Couples. The Journal of Sexual Medicine. Online First. doi: 10.1016/j.jsxm.2016.08.006 Access the paper: Full-Text Download (Paywall)

The year after the birth of a couple’s first child can often be a difficult one, as there is little that can prepare new parents for the many changes that come with the addition of a new member to the family. One major change that occurs during this time is to new parents’ sexual relationship 1,2. Indeed, research has shown that a majority of new parents have a number of questions or worries related to their sexual relationship. For example, many new parents worry about when to resume sexual intercourse after childbirth, whether sexual intercourse will be painful, the impact of new mother’s body image concerns on their interest in sex, and about differences in the degree to which new fathers and mothers are interested in sex 3.

While research has shown us that sexual concerns are very common among new parents 3, little is known about the impact that these concerns have on parents. For example, we do not know how severe these concerns are. Perhaps some new parents consider sexual concerns to be temporary and natural, and therefore not much to worry about. Alternatively, some new parents may experience sexual concerns as highly alarming and distressing. We also know very little about how sexual concerns impact new parent’s relationship quality. Could new parents who experience many sexual concerns, or perhaps a few severe sexual concerns, be at risk for relationship struggles? A couples’ sexual relationship has an important impact on the overall quality of their intimate relationship 4. Therefore, new parents who experience many sexual concerns, or severe sexual concerns, may also experience declines in the quality of their intimate relationship. When we designed this study, this is exactly what we sought out to explore.

What we did

239 North American new parent couples completed an online survey looking at 20 previously identified sexual concerns 3 and relationship satisfaction. All couples were first-time mothers and fathers to a healthy baby who was born 3 to 12 months before their participation in the study. We had fathers and mothers rate whether or not they were experiencing each of the 20 sexual concerns, and the severity of any of the concerns they were experiencing on a scale from 1 (not at all concerned) to 7 (extremely concerned). We also asked them to rate their relationship satisfaction using a well-established questionnaire called the Couples Satisfaction Index 5.

What we found

Overall, we found that sexual concerns were very common and moderately severe in new mothers and fathers alike. In fact 59% of mothers and fathers reported experiencing 16 or more of the 20 sexual concerns that were measured. The total severity of concerns were rated as 79 and 76 out of a total of 140 (56% and 54%) for new mothers and fathers respectively.

Top 5 sexual concerns of new mothers        

(1 – tie) Concerns about the frequency of intercourse after childbirth

(1 – tie) Concerns about changes new mothers’ body image and its impact of sexual activity after childbirth

(3) Concerns about the impact of child-rearing duties on time for sexual activity

(4) Concerns about the impact of sleep deprivation on sexual interest

(5) Concerns about the impact of physical recovery from delivery on intercourse

Top 5 sexual concerns of new fathers

(1) Concerns about mood swings (not postpartum depression) and their impact on sexual activity after childbirth

(2) Concerns about the frequency of intercourse after childbirth

(3) Concerns about a mismatch in sexual desire: new fathers have more sexual desire than new mothers

(4 – tie) Concerns about changes in new mother’s body image and its impact on sexual activity after childbirth

(4 – tie) concerns about the impact of breastfeeding on breasts


We also found that postpartum sexual concerns had an impact on relationship satisfaction. Fathers’ greater severity of postpartum sexual concerns was associated with their own and mothers’ reduced relationship satisfaction, while mothers’ greater severity of postpartum sexual concerns was only associated with lower relationship satisfaction in fathers. In addition, when mothers had more postpartum sexual concerns both they and their partner reported lower relationship satisfaction. However, fathers’ number of postpartum sexual concerns was unrelated to parents’ relationship satisfaction.

What does this mean?

Taken together, these findings show that sexual concerns are highly common and moderately severe in new mothers and fathers alike. New parent’s sexual concerns were also found to have an impact on both mothers’ and fathers’ relationship satisfaction. These findings therefore suggest that providing new parents with education or counselling about postpartum sexual concerns may have important positive impacts on the quality of their intimate relationship. Given that a healthy relationship is important not only for the wellbeing of new mothers and new fathers, but also for the healthy development of the child 6,7, it is highly recommended that health care providers discuss postpartum sexual concerns with new fathers and new mothers alike.


  1. Ahlborg T, Dahlof L-G, Hallberg, Lillemor R-M. Quality of the Intimate and Sexual Relationship in First-Time Parents Six Months After Delivery. J Sex Res. 2013;42(2):167-174.
  2. Benowitz NL, Jacob III P, Ahijevych K, et al. Biochemical verification of tobacco use and cessation. Nicotine Tob Res. 2002;4(2):149-159. doi:10.1080/14622200210123581.
  3. Pastore L, Owens A, Raymond C. Postpartum sexuality concerns among first-time parents from one U.S. academic hospital. J Sex Med. 2007;4(1):115-123. doi:10.1111/j.1743-6109.2006.00379.x.
  4. McNulty JK, Wenner CA, Fisher TD. Longitudinal Associations Among Relationship Satisfaction, Sexual Satisfaction, and Frequency of Sex in Early Marriage. Arch Sex Behav. 2016;45(1):85-97. doi:10.1007/s10508-014-0444-6.
  5. Funk JL, Rogge RD. Testing the ruler with item response theory: increasing precision of measurement for relationship satisfaction with the Couples Satisfaction Index. J Fam Psychol. 2007;21(4):572-583. doi:10.1037/0893-3200.21.4.572.
  6. Amato PR. Children of Divorce in the 1990s: An Update of the Amato and Keith (1991) Meta-Analysis. J Fam Psychol. 2001;15(3):355-370. doi:10.1037/0893-3200.15.3.355.
  7. Yu T, Pettit GS, Lansford JE, Dodge KA, Bates JE. The interactive effects of marital conflict and divorce on parent – adult children’s relationships. J Marriage Fam. 2010;72(2):282-292. doi:10.1111/j.1741-3737.2010.00699.x.




Maintaining affection despite pain: Daily associations between physical affection and sexual and relationship well-being in women with genito-pelvic pain

Posted on Sep 14, 2016

flickr-user_you-meBy Sarah Vannier

*Note: This is a summary of our recently published paper Vannier, S.A., Rosen, N.O., Mackinnon, S.P., & Bergeron, S. (2016). Maintaining affection despite pain: Daily associations between physical affection and sexual and relationship well-being in women with genito-pelvic pain. Archives of Sexual Behavior. Online First. doi: 10.1007/s10508-016-0820-5 Access the paper: Full-Text View Only (Open-Access), Full-Text Download (Paywall)

Provoked vestibulodynia (PVD) is the most common cause of genito-pelvic pain in premenopausal women and affects 8 to 12 % of women. Many women with PVD report that the condition has a negative effect on their sexual and relationship well-being [1]. The goal of this study was to look at the link between day-to-day physical affection with a romantic partner (i.e., hugging/kissing and cuddling) and sexual, relational, and pain outcomes in women with PVD.

Physical affection is an important part of our intimate and romantic relationships. Actions like kissing, hugging, caressing, and cuddling have been linked to greater sexual and relationship satisfaction [2-5], and touch from romantic partners can help to reduce stress [6, 7].

No research has looked at the link between physical affection, pain, and sexual and relationship well-being in women with PVD. On the one hand, some women with genito-pelvic pain report that affectionate contact (e.g., hugging and kissing) with their partner helps them to maintain intimacy in their relationship when they have difficulty engaging in sexual activity [8-11]. On the other hand, many women with genito-pelvic pain, report avoiding or limiting physical affection because they worry it might lead to painful sexual activity [11-14]. For example, in a recent study of Canadian women receiving treatment for PVD, 38% said that they avoided all forms of physical intimacy with their romantic partner [9]. This avoidance may be partially driven by a desire to prevent a painful encounter, but may also be driven by concern about “leading a partner on” and not wanting to reject a partner who is trying to initiate sexual activity.

What did we do?

Seventy women diagnosed with PVD completed the study. All women were in mixed-sex relationships and living with their partner. We used a daily diary method where women completed a short survey every day for 8-weeks. This daily diary method is useful because it helps us collect more accurate reports of women’s experiences (i.e., it is easier to remember what you did in the past 24 hours than to remember your typical behaviour over the past four weeks). The diary method also lets us look at the day-to-day changes in women’s lives. Each day women reported whether they had engaged in physical affection and sexual activity and rated their relationship satisfaction. On days when sexual activity occurred women also rated their sexual functioning, sexual satisfaction, and intensity of pain.

What did we find?

Many of the women in our sample were physically affectionate with their partner. On days with sexual activity, women hugged/kissed their partner eight times, and cuddled their partner twice, on average. On days with no sexual activity, women were slightly less affectionate; they report hugging/kissing five times and cuddling once, on average.

Affection was linked with sexual and relationship well-being. On days that women reported more affection they also reported increased satisfaction, relationship satisfaction, and sexual functioning. This was true for hugging and kissing that happened on the same day as sexual activity, and for hugging and kissing that happened on the day before sexual activity. Cuddling was not related to any of the sexual and relationship outcomes, and physical affection was not linked with women’s experiences of pain.



What does this mean?

Our findings suggest that physical affection, such as hugging and kissing, is associated with higher sexual satisfaction, relationship satisfaction, and better sexual functioning in the daily lives of women with PVD. Affection also appears to be helpful when it happens both within and outside of a sexual context. This means that hugging and kissing regularly, and on days when you do not have sex, may be helpful for women with PVD and their partners.

It is very common for women with PVD to report that physical affection with their partner produces negative emotions and avoidance, mostly driven by a fear that affection can lead to painful sexual activity [15-18]. However, our data suggest that maintaining affectionate contact with a partner may offer benefits for women with PVD and their romantic relationships. That said, we must keep in mind that this study was correlational. This means that we do not know if hugging and kissing more causes improvements in sexual and relationship well-being, or if women who are in better sexual and romantic relationships are also more likely to hug and kiss their partner. Longitudinal research, where we follow couples over time, will help us to tease apart this association. Overall, we hope that this data will inform future interventions aimed at enhancing the sexual and relationship well-being of women with PVD.


  1. Ponte, M., et al., Effects of vulvodynia on quality of life. Journal of the American Academy of Dermatology, 2009. 60(1): p. 70-76.
  2. Dainton, M., L. Stafford, and D.J. Canary, Maintenance strategies and physical affection as predictors of love, liking, and satisfaction in marriage. Communication Reports, 1994. 7(2): p. 88-98.
  3. Fisher, W.A., et al., 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, 2015. 44(6): p. 1609-1620.
  4. Gulledge, A.K., M.H. Gulledge, and R.F. Stahmann, Romantic physical affection types and relationship satisfaction. American Journal of Family Therapy, 2003. 31(4): p. 233-242.
  5. Muise, A., E. Giang, and E.A. Impett, Post sex affectionate exchanges promote sexual and relationship satisfaction. Archives of Sexual Behavior, 2014. 43(7): p. 1391-1402.
  6. Ditzen, B., et al., Effects of different kinds of couple interaction on cortisol and heart rate responses to stress in women. Psychoneuroendocrinology, 2007. 32(5): p. 565-574.
  7. Grewen, K.M., et al., Warm partner contact is related to lower cardiovascular reactivity. Behavioral Medicine, 2004. 29(3): p. 123-130.
  8. Blair, K.L., et al., 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, 2015. 41(5): p. 498-524.
  9. Brotto, L.A., et al., Impact of a multidisciplinary vulvodynia program on sexual functioning and dyspareunia. Journal of Sexual Medicine, 2015. 12(1): p. 238-247.
  10. Smith, K.B. and C.F. Pukall, A systematic review of relationship adjustment and sexual satisfaction among women with provoked vestibulodynia. Journal of Sex Research, 2011. 48(2-3): p. 166-191.
  11. Svedhem, C., G. Eckert, and B. Wijma, Living with genito-pelvic pain/penetration disorder in a heterosexual relationship: An interpretative phenomenological analysis of interviews with eight women. Sexual and Relationship Therapy, 2013. 28(4): p. 336-349.
  12. Hinchliff, S., M. Gott, and K. Wylie, A qualitative study of heterosexual women’s attempts to renegotiate sexual relationships in the context of severe sexual problems. Archives of Sexual Behavior, 2012. 41(5): p. 1253-1261.
  13. Marriott, C. and A.R. Thompson, Managing threats to femininity: Personal and interpersonal experience of living with vulval pain. Psychology and Health, 2008. 23(2): p. 243-258.
  14. Sutherland, O., Qualitative analysis of heterosexual women’s experience of sexual pain and discomfort. Journal of Sex & Marital Therapy, 2012. 38(3): p. 223-244.
  15. Gates, E.A. and R.P. Galask, Psychological and sexual functioning in women with vulvar vestibulitis. Journal of Psychosomatic Obstetrics and Gynecology, 2001. 22(4): p. 221-228.
  16. Nylanderlundqvist, E. and J. Bergdahl, Vulvar vestibulitis: Evidence of depression and state anxiety in patients and partners. Acta Dermato-Venereologica, 2003. 83(5): p. 369-373.
  17. Payne, K.A., et al., When sex hurts, anxiety and fear orient attention towards pain. European Journal of Pain, 2005. 9(4): p. 427-436.
  18. Payne, K.A., et al., 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, 2007. 36(2): p. 289-300.