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Provoked vestibulodynia affects 12% of the general female population and more specifically, 21% of women aged less than 30 years. Primary and secondary vestibulodynia are hypothesized to represent the endpoints of different etiologic pathways, although there is still little research addressing potential distinctions between these two groups, particularly with regard to sexuality. Aims: To compare sexual activity and behavior of women with provoked primary vestibulodynia (PVD1) and secondary vestibulodynia (PVD2) against age-matched controls. Methods: Fifty-seven participants (N = 57), mean age 25.72 (18-41) recruited from a gynecology clinic underwent a gynaecological examination and completed a self-report questionnaire: 20 (N = 20) were diagnosed with primary provoked vestibulodynia (PVD1), 19 (N = 19) with secondary provoked vestibulodynia (PVD2), and 18 (N = 18) were medically confirmed as no-pain controls. Main outcome: To verify any differences in the sexual behavior between primary, secondary vestibulodynias and controls. Results: Mean pain duration differed significantly in participants with PVD1 at 73.8 months against those with PVD2 at 37.4 months (p = 0.003). Frequency of sexual activity also differed significantly between the three groups (p = 0.012): the controls were at 27.8% against 0% in primary and secondary vestibulodynias for once or more a day. No significant difference was observed for the sexual arousal time and masturbation frequency. Vaginal penetration was overrepresented in controls (p 0.001) contrary to fellatio frequency (p = 0.016). Pain digital test was significantly different between the three groups in one finger (3.85 vs 0.08), two fingers (4.39 vs 0.06) or three fingers (5.39 vs 0.56) (PVD1 against controls), lubricated inserted fingers for pain verification (p 0.001). Conclusions: Provoked vestibulodynia generates problems in the sexual response and coital activity, this syndrome reflecting absence of pre-existing sexual problems, notably in the masturbatory activity and oral receptive female sex.

Sexual Behaviors in Women with Primary and Secondary Provoked Vestibulodynia: A Controlled Study