Dyspareunia as a chronic pain syndrome : a comparative study

The diagnosis of Dyspareunia relies on a woman's self-report of pain associated with sexual intercourse, and is reported to be a common and distressing condition. Considered within psychiatric classifications as primarily a sexual dysfunction, there has been little research on dyspareunia as a pain syndrome. In this study 11 women with dyspareunia were compared with 13 women with more generalised chronic pelvic pain, and a comparison group of 11 women with other recognised chronic pain syndromes. The groups were compared on various psychosocial measures including sexual functioning, relationship adjustment, anxiety, depression, beliefs about pain and pain intensity. It was hypothesised that women with dyspareunia would share many psychosocial characteristics with women experiencing other chronic pain syndromes. The data were analysed using nonparametric analysis of variance and correlational statistics. The study found many similarities between women with dyspareunia, chronic pelvic pain and other chronic pain syndromes on the measures of psychosocial functioning. In addition, significant relationships were found between the frequent experience of catastrophising self-statements and anxiety, with self-reports of pain ratings. The results suggest that impairments in sexual and relationship functioning may not be specific to women with dyspareunia. The findings provide support for the view, expressed recently in the literature, that dyspareunia may be more usefully considered as a chronic pain syndrome resulting in sexual difficulties. The findings highlight the role of cognitive factors that may promote or hinder attempts to cope with pain, and have important implications for possible psychological interventions. An integrative model of investigation and management is proposed, drawing on current biopsychosocial pain theories for women with dyspareunia and chronic pelvic pain.