Vulvodynia in heterosexual relationships

Understanding the role of social context and interpersonal dynamics

Abstract

Vulvodynia, a chronic genital pain disorder affecting about 15% of women, is linked to health issues like anxiety, depression, sexual dysfunction, distress, and other pain conditions. Often invisible beyond the woman's partner and overlooked, it can affect the male partner's sexual and mental health. Partner responses to pain, one of the most studied interpersonal factors influencing vulvodynia, can influence emotional regulation and relationship outcomes. Despite increased focus, vulvodynia remains under-researched, particularly its impact on partners and relationships. The thesis investigates the relational aspects of vulvodynia, exploring how the condition affects not only the women but also their partners, providing insights into the role of partners in the treatment and management of vulvodynia. In Study I, we explored the experiences of eight couples, focusing on how contextual factors influenced the women’s pain-coping strategies. In Study II, we explored the ambivalence and distress of the same male partners about conflicting masculine ideals. In Study III, we explored the associations between different partner responses (facilitative, solicitous, and negative) and demographic and psychosexual variables, as well as differences between men who reported being currently sexually active versus inactive. The three studies reveal that vulvodynia presents numerous challenges for couples, including understanding the condition, facing social exclusion, and navigating complex sexual norms. Male partners experience significant distress managing conflicting masculinity ideals and sexual expectations. The findings also highlight the link between partner responses and psychosexual health outcomes, relationship satisfaction, and the importance of mental health in managing vulvodynia. The couples’ experiences highlight the need for increased public awareness of vulvodynia, improved healthcare, and more open communication between partners. Based on our findings, we propose that the inclusion of both partners in the treatment of vulvodynia may be beneficial for improving relational dynamics, especially related to partner responses to pain and validation.