VENUS: CBT group program + for women with superficial dyspareunia - a randomised controlled trial

Recurring pain in the vulvovaginal regional induced by touch or pressure is thought to be the most frequent cause of superficial dyspareunia in premenopausal women. Its prevalence is 7-15% in community samples. It has an enormous impact on couples sexual function, sexual satisfaction, general psychological well-being and overall quality of life.

The last decade of research suggests that psychological factors, such as fear of pain, catastrophizing, and avoidance behavior may contribute to the maintenance and exacerbation of dyspareunia. These findings are  in line with the fear-avoidance model of pain where an initial pain experience may be interpreted as threatening (catastrophizing), leading to fear of pain and to avoidant behaviors, which in turn may lead to hypervigilance followed by disability (sexual dysfunction) and disuse (avoidance of sexual situations). Cognitive behavioral therapy (CBT) interventions aim at reducing pain, restoring sexual function and improving the romantic relationship by targeting the thoughts, emotions, behaviors and couple interactions associated with the experience of dyspareunia. Furthermore, given the interpersonal sexual context in which dyspareunia is most often triggered, relational factors is an important area to address. However, randomised controlled trials evaluating the effects for women with dyspareunia are still lacking.

The current study will employ a group CBT treatment program of 10 group sessions and 3 individual couple sessions targeting the thoughts, emotions, behaviors and couple interactions associated with the experience of dyspareunia. Women with superficial dyspareunia and their partners will be randomized to the CBT group program+ or a waiting list control period at two treatment locations in the Netherlands and one treatment location in Sweden. The waiting list control period will be comparable to the treatment duration of six months.