By Maria Glowacka

This post is a summary of our paper: Glowacka, M., Bergeron, S., Dubé, J., & Rosen, N. O. (2018). When self-worth is tied to one’s sexual and romantic relationship: Associations with well-being in couples coping with genito-pelvic pain. Archives of Sexual Behaviour, Advance online copy. doi: 10.1007/s10508-017-1126-y

Provoked vestibulodynia (PVD: recurrent vulvovaginal pain) is a common cause of women’s genito-pelvic pain [1]. Women with PVD and their romantic partners report reduced sexual satisfaction, greater sexual distress and depressive symptoms [2], as well as lower self-esteem [3, 4, 5].

Sexual contingent self-worth (CSW) is self-esteem that is dependent on maintaining what one perceives to be a successful sexual relationship [6]. When individuals with greater CSW experience positive events in the contingent domain, they have better well-being [7] However, if they perceive failures in the contingent domain (sexual domain), they have poorer well-being. One study found that individuals who reported sexual problems, such as PVD, had greater sexual CSW than those without problems [6].

Individuals with greater sexual CSW may perceive a sexual problem, such as PVD, as a failure in the contingent domain, which could be associated with poorer psychological, sexual, and relational well-being. Both women with PVD and their partners report feelings of failure in the sexual relationship [3, 4, 7, 8]. However, couples affected by PVD report being just as satisfied with their overall relationship as the general population [9]. Basing self-worth on the overall relationship (relationship CSW) may serve a protective function for couples coping with PVD [10].

In our study, we wanted to examine the associations between sexual and relationship CSW and the sexual satisfaction, sexual distress, relationship satisfaction, and depressive symptoms of women with PVD and their partners, as well as women’s pain.

What did we do?
We had 82 couples complete an online survey that included validated measures of sexual and relationship CSW and the sexual satisfaction, sexual distress, relationship satisfaction, depressive symptoms, and (for women) pain during intercourse.

What did we find?

  • When women with PVD reported greater sexual CSW, they experienced more sexual distress and pain.
  • When partners reported greater sexual CSW, they were less sexually and relationally satisfied and more sexually distressed, and women had greater depressive symptoms and lower relationship satisfaction.
  • When partners reported higher relationship CSW, they were more sexually and relationally satisfied and less sexually distressed, and women reported lower depressive symptoms and greater relationship satisfaction.

What do these findings mean?
Results suggest that couples’ greater sexual CSW is linked to poorer sexual, relational, and psychological well-being in couples affected by PVD, whereas partners’ greater relationship CSW is associated with better well-being. Thus, when couples coping with PVD base their self-worth on their sexual relationship, they may be more likely to experience the negative consequences that are associated to this pain condition  [2]. However, if partners are more focused on the overall romantic relationship, this may serve a protective function for both members of the couple.

Findings suggest that sexual and relationship CSW may be important targets for interventions aimed at improving the well-being of couples with PVD. The results also highlight the importance of including partners in research and treatment for PVD.

It is important to note that this study was cross-sectional. Thus, all of the associations could have been in the other direction. For example, it is possible that when couples coping with PVD have poorer psychological and sexual well-being, they are more likely to have greater sexual CSW. Further research is needed to help determine the direction of these associations.

Sources

[1] Bornstein, J., Goldstein, A. T., Stockdale, C. K., Bergeron, S., Pukall, C., Zolnoun, D., & Deborah Coady. (2016). 2015 ISSVD, ISSWSH and IPPS consensus terminology and classification of persistent vulvar pain and vulvodynia. The Journal of Sexual Medicine, 13, 607-612. doi:10.1097/AOG.0000000000001359

[2] Bergeron, S., Corsini-Munt, S., Aerts, L., Rancourt, K., & Rosen, N. O. (2015). Female sexual pain disorders: A review of the literature on etiology and treatment. Current Sexual Health Reports, 7, 159-169. doi:10.1007/s11930-015-0053-y

[3] Ayling, K., & Ussher, J. M. (2008). ”If sex hurts, am I still a woman?” The subjective experience of vulvodynia in hetero-sexual women. Archives of Sexual Behavior, 37, 294-304. doi:10.1007/s10508-007-9204-1

[4] Sadownik, L. A., Smith, K. B., Hui, A., & Brotto, L. A. (2016). The impact of a woman’s dyspareunia and its treatment on her intimate partner: A qualitative analysis. Journal of Sex & Marital Therapy, 43, 529-542. doi:10.1080/0092623X.2016.1208697

[5] Glowacka, M., Rosen, N. O., Vannier, S., & MacLellan, M. C. (2017). Development and validation of the Sexual Contingent Self-Worth Scale. The Journal of Sex Research, 54, 117-129. doi:10.1080/00224499.2016.1186587

[6] Crocker, J., & Wolfe, C. T. (2001). Contingencies of self worth. Psychological Review, 108, 593-623. doi:10.1037/0033-295X.108.3.593

[7] Marriott, C., & Thompson, A. R. (2008). Managing threats to femininity: Personal and interpersonal experience of living with vulval pain. Psychology & Health, 23, 243-258. doi:10.1080/14768320601168185

[8] Sheppard, C., Hallam-Jones, R., & Wylie, K. (2008). Why have you both come? Emotional, relationship, sexual and social issues raised by heterosexual couples seeking sexual therapy (in women referred to a sexual difficulties clinic with a history of vulval pain). Sexual and Relationship Therapy, 23, 217-226. doi:10.1080/14681990802227974

[9] Smith, K. B., & Pukall, C. F. (2011). A systematic review of relationship adjustment and sexual satisfaction among women with provoked vestibulodynia. Journal of Sex Research, 48, 166-191. doi:10.1080/00224499.2011.555016

[10] Knee, C. R., Canevello, A., Bush, A. L., & Cook, A. (2008). Relationship-contingent self-esteem and the ups and downs of romantic relationships. Journal of Personality and Social Psychology, 95, 608-627. doi:10.1037/0022-3514.95.3.608

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