Female Sexual Pain Disorders and Cognitive Behavioral Therapy‪.‬

Female sexual pain disorders are important to study because they can negatively affect both a woman's well-being and her romantic relationships. Despite the consequences of the disorders, there is a dearth of research on the topic. Of what is available, cognitive-behavioral therapy (CBT) interventions appear to be the most frequently studied, possibly because CBT addresses the psychological elements of pain. The purpose of this article is to provide a rationale for the use of CBT, provide a critical analysis of these research studies by evaluating each study in detail, and identify gaps in the research base. Sexual pain disorders are defined in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev. [DSM-IV-TR]; American Psychiatric Association [APA], 2000) as either dyspareunia or vaginismus. Dyspareunia is defined by the DSM-IV-TR as "(A) Recurrent or persistent genital pain associated with sexual intercourse in either a male or a female; (B) The disturbance causes marked distress or interpersonal difficulty; (C) The disturbance is not caused exclusively by Vaginismus or lack of lubrication, is not better accounted for by another Axis I disorder (except another Sexual Dysfunction), and is not due exclusively to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition" (p. 556). Vulvodynia, pain in the vulva, and its subtype, provoked vestibulodynia (also referred to as vulvar vestibulitis), pain in the vulvar vestibule area, are both types of dyspareunia. Although the definition of dyspareunia includes males, this article only addresses research with females.