(085) DAILY CHANGES IN GENITAL PAIN, NON-GENITAL PAIN, AND MOOD, AS PREDICTORS OF SEXUAL DESIRE AND SEX WITH PARTNER: THE ROLE OF POSITIVE MOOD AND THE NEED FOR A POSITIVE PSYCHOLOGY OF SEX
Authors: Kiesner J , Bittoni C 
Published: June 2024

Abstract

Introduction
There is a lack of research using prospective daily reports to study the associations between genital pain, psychological state, and sexual function. Although many studies have examined the relations among these variables, the most common strategy used is one-time retrospective accounts, which are limited by recall bias and the inability to study day-to-day variations in these symptoms.

Objective
To examine how day-to-day changes in genital pain influence daily changes in negative mood, and how day-to-day changes in genital pain and psychological symptoms are associated with daily changes in sexual desire and having sex with a partner.

Methods
A sample of 258 women with genital pain completed daily surveys measuring pain symptoms, psychological state, and sexual desire and activity (n=5831 surveys total; M=20.6 surveys per participant). Daily reports of genital pain addressed pain intensity, duration, and type (continuous vs intermittent); daily reports of psychological state addressed feeling depressed, tense/on edge, happy, and attractive/beautiful; and daily reports of non-genital pain addressed headaches and cramps. Presence of menstruation was also queried. Multilevel analyses tested for effects of genital pain on negative mood; and for effects of all pain and psychological symptoms on sexual desire and sex with partner.

Results
Analyses presented in tables 1 and 2 consider only days when genital pain was present (3316 surveys; 57% of surveys). Analyses including days with no genital pain were also conducted, recoding pain intensity and duration as zero, and excluding pain type, with only minor changes in results which did not change the overall conclusions. Table 1 presents results from models testing for effects of genital pain on feeling depressed and feeling tense/on edge, and show that, controlling for random intercepts of individual participants, feeling depressed was significantly predicted by all three pain scores, whereas feeling tense/on edge was predicted only by pain intensity and duration. Table 2 presents results from models predicting sexual desire/libido and having sex with partner from all predictor variables while controlling for random intercepts of individual participants. Overall, the results from these models show that the strongest and most consistent predictors across the two outcomes were the psychological variables of feeling tense/on edge, feeling happy and feeling attractive. Feeling depressed had no effect on either outcome. Of the genital pain symptoms, only pain duration had an effect on desire, whereas both pain duration and intensity predicted sex with partner. Pain intensity showed a positive association with sex with partner, which likely reflects an increase in pain intensity after having sex.

Conclusions
The current findings illustrate the potential impact of genital pain on negative emotions, as well as the importance of positive mood (feeling happy and attractive) on sexual desire and activity. Whereas past research has often focused on negative affect as an outcome of genital pain1, and as a predictor of sexual function2, the present study suggests that we give more attention to positive mood and a positive psychology approach3 in addressing the link between genital pain and sexual function. Such an approach may also have broader implications for general wellness.

Disclosure
Yes, this is sponsored by industry/sponsor: Data was partially collected using the app “Vulvae”, which is a free-to-use app, and presents no conflict of interest for either of the authors.
Clarification: No industry support in study design or execution.