Role of sexuality in women with chronic pain: results from an Italian cross-sectional study on chronic headache, fibromyalgia, and vulvodynia

• Filippo Maria Nimbi ^[1] ; Martina Mesce ^[1] ; Erika Limoncin ^[1] ; Alessia Renzi ^[1] ; Federica Galli ^[1]
  1. [1] Università de Roma La Sapienza

     Università de Roma La Sapienza

     Roma Capitale, Italia

     
• Localización: International journal of clinical and health psychology, ISSN 1697-2600, Vol. 24, Nº. 2, 2024, págs. 291-300
• Idioma: inglés
• DOI: 10.1016/j.ijchp.2024.100472
• Enlaces
  • Texto completo
• Resumen

  • Background/objectives To compare sexual functioning, genital pain, and satisfaction among women diagnosed with various Chronic pain (CP) conditions. Additionally, it seeks to explore the role of sexual factors in predicting levels of central sensitization (indicative of CP-related mental and physical distress), physical, and mental quality of life (QoL) for each condition individually.

    Methods From April 2023 to January 2024, 1006 women categorized into five groups (Chronic Headache - CH; Fibromyalgia - FM, Vulvodynia - VU, Comorbidity group - CO, and Healthy Controls - HC) completed an online protocol.

    Results All groups reported sexual impairment: VU group exhibited the highest genital pain prevalence (97.93 %), followed by CO (74.29 %) and FM (55.91 %). ANCOVAs indicated lower sexual functioning scores for FM, VU, and CO compared to HC and CH. VU and CO reported lower satisfaction scores than other groups. Genital pain emerged as the primary predictor of central sensitization across all groups except controls. Regarding mental QoL, sexual satisfaction was significant for CH and CO, while genital pain and sexual satisfaction were significant for VU.

    Conclusion This study emphasizes the importance of integrating genito-pelvic pain assessment and addressing related sexual difficulties in CP diagnostics and care to enhance overall well-being and QoL.

• Referencias bibliográficas
  • Adams, G. R., Gandhi, W., Harrison, R., van Reekum, C. M., Wood-Anderson, D., Gilron, I., et al. (2023). Do “central sensitization” questionnaires...
  • Basson, R. (2000). The female sexual response: A different model. Journal of Sex & Marital Therapy, 26(1), 51–65. https://doi.org/10.1080/009262300278641
  • Birke, H., Ekholm, O., Højsted, J., Sjøgren, P., & Kurita, G. P. (2019). Chronic pain, opioid therapy, sexual desire, and satisfaction...
  • Bornstein, J., Goldstein, A. T., Stockdale, C. K., Bergeron, S., Pukall, C., Zolnoun, D., & International Society for the Study of Vulvovaginal...
  • Bornstein, J., Palzur, E., Swash, M., & Petros, P. (2022). Vulvodynia: A neuroinflammatory pain syndrome originating in pelvic visceral...
  • Breton, A., Miller, C. M., & Fisher, K. (2008). Enhancing the sexual function of women living with chronic pain: A cognitive-behavioural...
  • Burri, A., Lachance, G., & Williams, F. M. K. (2014). Prevalence and risk factors of sexual problems and sexual distress in a sample of...
  • Caponnetto, V., Deodato, M., Robotti, M., Koutsokera, M., Pozzilli, V., Galati, C., et al. (2021). Comorbidities of primary headache disorders:...
  • Casale, R., Atzeni, F., Bazzichi, L., Beretta, G., Costantini, E., Sacerdote, P., et al. (2021). Pain in women: A perspective review on a...
  • Chiarotto, A., Viti, C., Sulli, A., Cutolo, M., Testa, M., & Piscitelli, D. (2018). Cross- cultural adaptation and validity of the Italian...
  • Chisari, C., Monajemi, M. B., Scott, W., Moss-Morris, R., & McCracken, L. M. (2021). Psychosocial factors associated with pain and sexual...
  • Cohen, S. P., Vase, L., & Hooten, W. M. (2021). Chronic pain: An update on burden, best practices, and new advances. The Lancet, 397(10289),...
  • Collado-Mateo, D., Olivares, P. R., Adsuar, J. C., & Gusi, N. (2020). Impact of fibromyalgia on sexual function in women. Journal of Back...
  • Connor, J. J., Haviland, M., Brady, S. S., Robinson, B. B. E., & Harlow, B. L. (2020). Psychosocial factors influence sexual satisfaction...
  • Dagostin Ferraz, S., Rodrigues Candido, A. C., Rodrigues Uggioni, M. L., Colonetti, T., Santina Dagostin, V., & Rosa, M. I. (2024). Assessment...
  • Dahlhamer, J., Lucas, J., Zelaya, C., Nahin, R., Mackey, S., DeBar, L., et al. (2018). Prevalence of Chronic Pain And High-Impact Chronic...
  • Dewitte, M., Borg, C., & Lowenstein, L. (2018). A psychosocial approach to female genital pain. Nature Reviews. Urology, 15(1), 25–41....
  • Dewitte, M., & Reisman, Y. (2021). Clinical use and implications of sexual devices and sexually explicit media. Nature Reviews Urology,...
  • Doggweiler, R., Whitmore, K. E., Meijlink, J. M., Drake, M. J., Frawley, H., Nordling, J., et al. (2017). A standard for terminology in chronic...
  • Edwards, S., Mandeville, A., Petersen, K., Cambitzi, J., Williams, A. C., de, C., et al. (2020). ‘ReConnect’: A model for working with persistent...
  • Enzlin, P., & Clippeleir, D. (2011). The emerging field of «oncosexology»: Recognising the importance of addressing sexuality in oncology....
  • Filocamo, M. T., Serati, M., Li Marzi, V., Costantini, E., Milanesi, M., Pietropaolo, A., et al. (2014). The Female Sexual Function Index...
  • Finn, E., Morrison, T. G., & McGuire, B. E. (2018). Correlates of sexual functioning and relationship satisfaction among men and women...
  • Fitzcharles, M. A., Cohen, S. P., Clauw, D. J., Littlejohn, G., Usui, C., & Hauser, W. (2021). Nociplastic pain: Towards an understanding...
  • Flegge, L. G., Barr, A., & Craner, J. R. (2023). Sexual functioning among adults with chronic pain: Prevalence and association with pain-related...
  • Flynn, K. E., Lin, L., Bruner, D. W., Cyranowski, J. M., Hahn, E. A., Jeffery, D. D., et al. (2016). Sexual satisfaction and the importance...
  • Forbes, M. K., Eaton, N. R., & Krueger, R. F. (2017). Sexual quality of life and aging: A prospective study of a nationally representative...
  • Galli, F. (2023). Understanding nociplastic pain: Building a bridge between clinical psychology and medicine. Journal of Personalized Medicine,...
  • Ghizzani, A., Di Sabatino, V., Suman, A. L., Biasi, G., Santarcangelo, E. L., & Carli, G. (2014). Pain symptoms in fibromyalgia patients...
  • Gordon, A., Paneduro, D., Pink, L., Lawler, V., & Lay, C. (2014). Evaluation of the frequency and the association of sexual pain and chronic...
  • Granero-Molina, J., Jimenez-Lasserrotte, M., del, M., Dobarrio-Sanz, I., Correa- Casado, M., Ramos-Rodríguez, C., et al. (2023). Sexuality...
  • Hammerli, S., Kohl-Schwartz, A., Imesch, P., Rauchfuss, M., Wolfler, M. M., Haberlin, F., et al. (2020). Sexual satisfaction and frequency...
  • Harlow, B. L., Kunitz, C. G., Nguyen, R. H. N., Rydell, S. A., Turner, R. M., & MacLehose, R. F. (2014). Prevalence of symptoms consistent...
  • James, S. L., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., et al. (2018). Global, regional, and national incidence, prevalence,...
  • Johnston, K.J.A., Signer, R., & Huckins, L.M. (2023). Chronic overlapping pain conditions and nociplastic pain (p. 2023.06.27.23291959)....
  • Kosek, E., Clauw, D., Nijs, J., Baron, R., Gilron, I., Harris, R. E., et al. (2021). Chronic nociplastic pain affecting the musculoskeletal...
  • Lamvu, G., Carrillo, J., Ouyang, C., & Rapkin, A. (2021). Chronic pelvic pain in women: A review. JAMA, 325(23), 2381–2391. https://doi.org/10.1001/jama.2021.2631
  • Marinoff, S. C., & Turner, M. L. (1992). Vulvar vestibulitis syndrome. Dermatologic Clinics, 10(2), 435–444.
  • Marques, A. P., Santo, A. D. S. D. E., Berssaneti, A. A., Matsutani, L. A., & Yuan, S. L. K. (2017). Prevalence of fibromyalgia: Literature...
  • Martinez-Lavin, M. (2020). Fibromyalgia in women: Somatisation or stress-evoked, sex- dimorphic neuropathic pain? Clinical and Experimental...
  • Mautz, T. T., Mulroy, M. E., Krapf, J. M., Goldstein, A. T., & Pukall, C. F. (2023). Pleasure despite pain: Associations between experiences...
  • Mayer, T. G., Neblett, R., Cohen, H., Howard, K. J., Choi, Y. H., Williams, M. J., et al. (2012). The development and psychometric validation...
  • McGrath, M., Low, M. A., Power, E., McCluskey, A., & Lever, S. (2021). Addressing sexuality among people living with chronic disease and...
  • Meana, M., Fertel, E., & Maykut, C. (2017). Treating genital pain associated with sexual intercourse. The wiley handbook of sex therapy...
  • Melzack, R. (1987). The short-form McGill pain questionnaire. Pain, 30(2), 191–197. https://doi.org/10.1016/0304-3959(87)91074-8
  • Meston, C., & Trapnell, P. (2005). Development and validation of a five-factor sexual satisfaction and distress scale for women: The Sexual...
  • Mona, L. R., Syme, M. L., & Cameron, R. P. (2014). Sexuality and disability: A disability- affirmative approach to sex therapy. Principles...
  • Nappi, R. E., Terreno, E., Tassorelli, C., Sances, G., Allena, M., Guaschino, E., et al. (2012). Sexual function and distress in women treated...
  • Nijs, J., Lahousse, A., Kapreli, E., Bilika, P., Saraçog˘lu, I˙., Malfliet, A., et al. (2021). Nociplastic pain criteria or recognition of...
  • Nimbi, F. M., Galizia, R., Rossi, R., Limoncin, E., Ciocca, G., Fontanesi, L., et al. (2021). The biopsychosocial model and the sex-positive...
  • Nimbi, F. M., Rossi, R., Tripodi, F., Wylie, K., & Simonelli, C. (2019). A biopsychosocial model for the counseling of hormonal contraceptives:...
  • Nimbi, F. M., Rossi, V., Tripodi, F., Luria, M., Flinchum, M., Tambelli, R., et al. (2020). Genital pain and sexual functioning: Effects on...
  • Offenbaecher, M., Kohls, N., Ewert, T., Sigl, C., Hieblinger, R., Toussaint, L. L., et al. (2021). Pain is not the major determinant of quality...
  • Piarulli, A., Conversano, C., Ciacchini, R., Miniati, M., Marchi, L., Bazzichi, L., et al. (2021). Catastrophisation, chronic pain and sexuality:...
  • Pukall, C. F., Bergeron, S., Rosen, N. O., & Jackowich, R. (2020). Persistent genitopelvic pain: Classification, comorbidities, chronicity,...
  • Raja, S. N., Carr, D. B., Cohen, M., Finnerup, N. B., Flor, H., Gibson, S., et al. (2020). The revised international association for the study...
  • Ricoy-Cano, A. J., Cortes-Perez, I., del Carmen Martín-Cano, M., & De La Fuente-Robles, Y. M. (2022). Impact of fibromyalgia syndrome...
  • Rosen, C. B., Heiman, J., Leiblum, S., Meston, C., Shabsigh, R., Ferguson, D., et al. (2000). The Female Sexual Function Index (FSFI): A multidimensional...
  • Rossi, V., Galizia, R., Tripodi, F., Simonelli, C., Porpora, M. G., & Nimbi, F. M. (2022). Endometriosis and sexual functioning: How much...
  • Rossi, V., Tripodi, F., Simonelli, C., Galizia, R., & Nimbi, F. M. (2021). Endometriosis- associated pain: A review of quality of life,...
  • Rossi, V., Viozzi, E., Tripodi, F., Porpora, M. G., Simonelli, C., & Nimbi, F. M. (2020). Endometriosis, sexuality and satisfaction: A...
  • Ruschak, I., Monteso-Curto, P., Rossello, L., Aguilar Martín, C., Sanchez-Monteso, L., & Toussaint, L. (2023). Fibromyalgia syndrome pain...
  • Santos-Iglesias, P., Crump, L., Henry, J. L., LaChapelle, D. L., & Byers, E. S. (2022). The sexual lives of women living with fibromyalgia:...
  • Sarzi-Puttini, P., Giorgi, V., Marotto, D., & Atzeni, F. (2020). Fibromyalgia: An update on clinical characteristics, aetiopathogenesis...
  • Solmaz, V., Ceviz, A., Aksoy, D., Cevik, B., Kurt, S., Gencten, Y., et al. (2016). Sexual dysfunction in women with migraine and tension-type...
  • Stovner, L. J., Hagen, K., Linde, M., & Steiner, T. J. (2022). The global prevalence of headache: An update, with analysis of the influences...
  • Vasileva, P., Strashilov, S., & Yordanov, A. (2020). Aetiology, diagnosis, and clinical management of vulvodynia. Menopause Review/Przegląd...
  • Wammen Rathenborg, F. L., Zdaniuk, B., & Brotto, L. A. (2019). What do different measures of pain tell us? A comparison in sexually active...
  • Ware, J. E., & Gandek, B. (1998). Overview of the SF-36 health survey and the International Quality of Life Assessment (IQOLA) project....
  • Ware, J. E., Kosinski, M., & Keller, S. D. (1996). A 12-item short-form health survey: Construction of scales and preliminary tests of...
  • Wolfe, F., Ablin, J., Guymer, E. K., Littlejohn, G. O., & Rasker, J. J. (2020). The relation of physical comorbidity and multimorbidity...
  • Wolfe, F., Clauw, D. J., Fitzcharles, M. A., Goldenberg, D. L., Hauser, W., Katz, R. L., et al. (2016). 2016 Revisions to the 2010/2011 fibromyalgia...