Two to Tango: New Interpersonal Model of Women’s Sexual Dysfunction

By Jackie Huberman

This blog is a summary of our published article: Rosen, N. O., & Bergeron, S. (2019). Genito-pelvic pain through a dyadic lens: Moving toward an interpersonal emotion regulation model of women’s sexual dysfunction. The Journal of Sex Research, 56, 440–461.

Sexual problems are more common in women than you might think – about a third of women report some kind of sexual difficulty! [1] One in four women struggle with low sexual interest or arousal, and 35-45% of women have genito-pelvic pain with sexual activity. [1, 2] With growing research on women’s distressing sexual difficulties – also known as sexual dysfunction – Drs. Rosen and Bergeron thought it was time for a new model of women’s sexual dysfunction. [2]


What did they do?

In a review paper published in the Journal of Sex Research, [2] Drs. Rosen and Bergeron reviewed research on factors involved in women’s sexual dysfunction. They then outlined a theoretical model of women’s sexual dysfunction, linking it with existing theories and research findings, and discussed its implications for women’s sexuality.

What is a model of women’s sexual dysfunction, anyways?

We know that no two women will experience their sexuality in the same way. Yet, through years of research asking women about their experiences, researchers have been able to map out some common patterns, and even identify factors that contribute to some women’s sexual difficulties. This is important for tailoring efforts in education and/or treatment to help women as much as possible!

So what’s new or interesting about this model?

Most past models of sexual dysfunction focused on only one individual’s experiences. But we know that when a woman experiences a sexual difficulty, she is often experiencing it within a relationship. The latest research suggests that it is important to look at both members of a couple when one is struggling with sexuality. For example, in women coping with genito-pelvic pain during sexual activity, the way a partner responds to a woman’s pain can affect the couple’s sexual wellbeing. [3]

With all this in mind, Drs. Rosen and Bergeron introduced an interpersonal model of women’s sexual dysfunction to account for dynamics within couples. Below is a visual of the model. It’s a lot to wrap your mind around, so we’ll break it down with an example.

Imagine that there are two people in a relationship, named Joan and CJ. Joan often has genito-pelvic pain during sex. They engage in sexual activity, and Joan expresses that she is in a lot of pain. How do Joan and CJ cope with this? What affects how they each respond to the situation and how they’ll manage as a couple? Let’s consider each part of the model shown above.

  • “Distal” or far-back factors: Both Joan and CJ have their own histories and past experiences that affect how they may cope with the current sexual challenge. These can include their social contexts, childhood interpersonal experiences, or what they learnt growing up about emotions or talking about sexuality.
  • “Proximate” or recent factors: Both Joan and CJ also have their own experiences before, during, and immediately after they face the sexual challenge. These can include their mood, motivation for sexual activity, or their interpretation of how the other person responded.
  • Couple Emotion Regulation: When Joan and CJ face a sexual difficulty, like pain during sex, each of their far-back and recent factors affect how they respond as a couple. Some couples have difficulties being aware of, expressing, or experiencing their emotions – they may, in turn, try to regulate emotions with strategies that are not beneficial to them in the long-term, like emotional outbursts or suppressing emotions [4]. Other couples might be able to engage in strategies that are more helpful, such as problem-solving, mindfulness, or re-appraising the experience [4].
  • Couple Outcomes: The ways Joan and CJ are able to regulate their emotions, in the face of a sexual challenge, can influence each of their sexual and emotional experiences. Couple outcomes in this model can include a woman’s pain, both partners’ sexual function, sexual or relationship satisfaction, or distress.

Why is this new interpersonal model important?

While there will never be a “one size fits all” model of sexual dysfunction, having a strong working model can help researchers identify areas that need further research. A comprehensive model also allows researchers and clinicians to test strategies that may help couples cope with sexual difficulties. By factoring in both members of the couples’ experiences into the model and considering how couples cope with emotions and sexual challenges together, future research may be able to identify new and even more effective strategies for couples coping with sexual difficulties.


[1] Shifren, J. L., Monz, B. U., Russo, P. A., Segreti, A., & Johannes, C. B. (2008). Sexual problems and distress in united states Women. Obstetrics and Gynecology, 112, 970–978.

[2] Rosen, N. O., & Bergeron, S. (2019). Genito-pelvic pain through a dyadic lens: Moving toward an interpersonal emotion regulation model of women’s sexual dysfunction. The Journal of Sex Research, 56, 440–461.

[3] Rosen, N. O., Bergeron, S., Sadikaj, G., Glowacka, M., Delisle, I., & Baxter, M. L. (2014). Impact of male partner responses on sexual function in women with vulvodynia and their partners: A dyadic daily experience study. Health Psychology, 33, 823.

[4] Dubé, J. P., Corsini-Munt, S., Muise, A., & Rosen, N. O. (2019). Emotion regulation in couples affected by female sexual interest/arousal disorder. Archives of Sexual Behavior, 48, 2491–2506.