Maillé Delphine L, Bergeron Sophie, Lambert Bernard
Department of Psychology, Université de Montréal, Montreal, Quebec, Canada.
J Sex Med. 2015 Feb;12(2):505-15. doi: 10.1111/jsm.12765. Epub 2014 Nov 13.
Provoked vestibulodynia (PVD) is a women's genito-pelvic pain condition associated with psychosexual impairments, including depression. Body image (BI) has been found to be different in women with primary (PVD1) and secondary (PVD2) PVD. No controlled study has compared BI in women with PVD1 and PVD2 and investigated its associations with sexual satisfaction, sexual function, and pain.
The aims of this study were to (i) compare BI in women with PVD1, PVD2, and asymptomatic controls and (ii) to examine associations between BI and sexual satisfaction, sexual function, and pain during intercourse in women with PVD.
Fifty-seven women (20 with PVD1, 19 with PVD2, and 18 controls) completed measures of BI, sexual satisfaction, sexual function, pain during intercourse, and depression.
The main outcome measures were (i) Global Measure of Sexual Satisfaction Scale, (ii) Female Sexual Function Index, and (iii) pain numerical rating scale.
Controlling for depression, women with PVD1 reported more body exposure anxiety during sexual activities than women with PVD2 and controls F(2,51)=4.23, P=0.02. For women with PVD, more negative BI during sexual activities was associated with lower sexual satisfaction (β=-0.45, P=0.02) and function (β=-0.39, P=0.04) and higher pain during intercourse (β=0.59, P=0.004). More positive body esteem was associated with higher sexual function (β=0.34, P=0.05).
Findings suggest that women with PVD1 present more body exposure anxiety during sexual activities than women with PVD2 and asymptomatic women. Body esteem and general attitudes toward women's genitalia were not significantly different between groups. Higher body exposure anxiety during sexual activities was associated with poorer sexual outcomes in women with PVD. Further studies assessing interventions targeting BI during sexual activities in this population are needed, as improving BI during sexual interactions may enhance sexual outcomes in women with PVD.
诱发性前庭痛（PVD）是一种女性生殖器 - 盆腔疼痛疾病，与包括抑郁症在内的心理性性功能障碍有关。研究发现，原发性（PVD1）和继发性（PVD2）PVD女性的身体意象（BI）存在差异。尚无对照研究比较PVD1和PVD2女性的BI，并调查其与性满意度、性功能和疼痛的关系。
本研究的目的是（i）比较PVD1、PVD2女性和无症状对照者的BI，以及（ii）检查PVD女性的BI与性满意度、性功能和性交疼痛之间的关联。
57名女性（20名PVD1患者、19名PVD2患者和18名对照者）完成了BI、性满意度、性功能、性交疼痛和抑郁的测量。
主要结局指标为（i）性满意度总体测量量表，（ii）女性性功能指数，以及（iii）疼痛数字评定量表。
在控制抑郁症的情况下，PVD1女性在性活动中报告的身体暴露焦虑比PVD2女性和对照者更多，F(2,51)=4.23，P = 0.02。对于PVD女性，性活动中更负面的BI与较低的性满意度（β=-0.45，P = 0.02）和性功能（β=-0.39，P = 0.04）以及较高的性交疼痛（β=0.59，P = 0.004）相关。更积极的身体自尊与较高的性功能相关（β=0.34，P = 0.05）。
研究结果表明，PVD1女性在性活动中比PVD2女性和无症状女性表现出更多的身体暴露焦虑。各组之间在身体自尊和对女性生殖器的总体态度上没有显著差异。性活动中较高的身体暴露焦虑与PVD女性较差的性结局相关。需要进一步研究评估针对该人群性活动中BI的干预措施，因为改善性互动中的BI可能会提高PVD女性的性结局。
