Sexual Arousal in Women with Superficial Dyspareunia

The role of sexual arousal in the etiology and/or maintenance of superficial dyspareunia is still unclear. Lack of sexual arousal may be both the cause and the result of anticipated pain. This study compared genital and subjective sexual responses to visual sexual stimuli of women with dyspareunia and women without sexual complaints. We investigated whether women with dyspareunia were less genitally and subjectively responsive to noncoital (oral sex) as well as coital visual sexual stimuli than women without sexual problems, or whether they exhibited a conditioned anxiety response such that sexual arousal responses were lower only to stimuli that may induce fear of pain (i.e., coitus). A total of 50 women with dyspareunia and 25 women without sexual problems were shown two sexual stimuli, one depicting oral sex and the other one depicting coitus. Genital arousal was assessed as vaginal pulse amplitude using vaginal photoplethysmography. Self-reported ratings of subjective sexual arousal were collected after each erotic stimulus presentation. Women with dyspareunia had comparable levels of genital arousal to two different visual sexual stimuli as women without sexual complaints. Contrary to expectation, there was an indication that women with dyspareunia reacted with higher levels of genital arousal to the explicitly depicted coitus stimulus than controls, whereas controls had higher genital responses to the oral sex stimulus. With respect to subjective sexual arousal, it was found that women with dyspareunia reported less positive feelings in response to both erotic stimuli than controls. We conclude that, with adequate visual sexual stimulation, women with dyspareunia showed equal levels of genital sexual arousal to visual sexual stimuli as women without sexual complaints. Therefore, there was no evidence for impaired genital responsiveness associated with dyspareunia. Also, we found no evidence for a conditioned anxiety reaction in response to exposure to a coitus scene.