• Geneviève Desrochers, Sophie Bergeron, Samir Khalifé, Marie-Josée Dupuis, and Mélanie Jodoin.
• Département de sexologie, Université du Québec à Montréal, QC, CA. genevieve.desrochers@internet.uqam.ca
• Clin J Pain. 2009 Jul 1;25(6):520-7.

BackgroundProvoked vestibulodynia is believed to be the most frequent cause of vulvodynia in women of childbearing age, with prevalence rates of up to 12% in the general population. Despite this high prevalence and the fact that vestibulodynia impacts negatively on quality of life, in particular sexual functioning, there has been a paucity of sound research to elucidate the condition's etiology. More specifically, few studies have focused on the role of psychologic factors in the experience of vulvo-vaginal pain and associated sexual impairment.ObjectivesThe present study aimed to determine the extent to which fear avoidance variables (catastrophizing, anxiety, fear of pain, hypervigilance) and self-efficacy differentially influenced changes in levels of induced and intercourse pain and also associated sexual dysfunction in these women.MethodsData were obtained from 75 vestibulodynia participants who completed a gynecologic examination, structured interview, and standardized questionnaires.ResultsThe results of regression analyses revealed that higher catastrophizing, fear of pain, and hypervigilance in addition to lower self-efficacy together accounted for 15% of the variation in increased intercourse pain intensity. Among these, only catastrophizing contributed unique variance to intercourse pain. Results also showed that higher state anxiety and fear of pain (escape/avoidance) and also lower self-efficacy explained 22% of the variation in women's sexual impairment. However, only self-efficacy was found to be an independent correlate of sexual impairment.ConclusionFindings support a theoretical model of vestibulodynia as a pain disorder influenced among others by cognitive and affective factors.

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