is sex worth the pain? willingness to engage in sexual ac8vity among partnered women ... ·...
TRANSCRIPT
IsSexWorthThePain?WillingnessToEngageInSexualAc8vityAmongPartneredWomenWithFibromyalgiaKirstenM.Gullickson1,LyndsayCrump1,DianeL.LaChapelle1,PabloSantos-Iglesias2,&E.SandraByers1
1DepartmentofPsychology,UniversityofNewBrunswick2DepartmentofOncology,UniversityofCalgary
INTRODUCTION BACKGROUND• Upto97%ofpaOentswithfibromyalgia(FM)reportitadversely
affectstheirsexuallives1.• CommonlyreportedimpactsofFMonsexualwell-beinginclude
decreasedsexualfrequency,lowersexualdesire,difficultywitharousalandorgasm,andreducedsexualsaOsfacOon2-3.
• However,previousresearchhasnotassessed:• Women’swillingnesstoengageinsexualacOvitydespiteFM• TheextenttowhichwomenwithFMviewthechangesto
theirsexuallivesasdistressingtothemselvesortheirpartners
• ImprovingourunderstandingoftheimpactofFMonwomen’ssexuallivesisessenOalbecausesexualwell-beingisanimportantcontributortorelaOonshipsaOsfacOonandstability,psychologicalhealth,andqualityoflife4.
PURPOSE• Thisprojectwaspartofalargerstudyexploringwomen’slived
experiencesoftheimpactofFMontheirsexualwell-being• Ouraimwastounderstandwomen’s:
• FeelingsaboutFM-relatedchangestotheirsexuallives• PercepOonsofhowthesechangesaffecttheirrelaOonship• WillingnesstoadjusttheirsexualscriptstoaccommodateFM
METHOD PARTICIPANTS• 16womenwithFMwhowereinacommiaedromanOcrelaOonship• Age(years):M=45.19;SD=12.03;Range=28-67• Rela1onshiplength(years):M=14.4;SD=12.31;Range=1-43• Timesincediagnosis(years):M=10.08;SD=6.56,Range=3-22
PROCEDURE• Audio-recordedsemi-structuredinterviewsinpersonorvia
telephonelasOngapproximately60to90minutesANALYSES• SemanOcandlatentcontentwascodedbasedontheprinciplesof
ThemaOcAnalysis5
RESULTS/DISCUSSION • ConsistentwithexisOngliterature,thevastmajorityofwomenreportedexperiencingchangesintheirsexuallivesasaresultofFM(e.g.,pain,faOgue,depression,medicaOonside-effects,negaOvebodyimage)1-3.• LatentcontentunderlyingparOcipants’narraOvessuggestedsexwasavaluedac8vityforsomewomen,butnotothers.• Relatedtothis,somewomenexpressedwillingnesstoengageinsexdespiteFM,whileothersdescribedliOletonowillingnesstoengageinsex.
• WillingindividualsdescribedaaemptstoadjusttheirsexualscriptstoaccommodateFMbychangingtheOming,duraOon,locaOon,ornatureoftheirsexualencounters.• ParOcipantsreportedvaryinglevelsofpersonaldistressandrela8onshipconflictasaresultofthesexualimpactsofFM.
• Forwomenwhosesexualbehaviourwasconsistentwiththeirsexualvalues,lowerlevelsofpersonaldistressandinterpersonalconflictwerereported:• Group1:valuedsexandwerewillingtoengageinsexdespiteFM• Group3:didnotengageinsexbecauseitwasnotastronglyheldvalue
• Forwomenwhosesexualbehaviourwasnotconsistentwiththeirvalues,higherlevelsofpersonaldistressandinterpersonalconflictwerereported:• Group2:valuedsex,butwereunwillingtoengageinsexualacOvityduetotheirillness• Group4:engagedinsexdespitenotvaluingsexasameansofreducingconflictoroutoffearoflosingtheirrelaOonship
REFERENCES1. Fitzcharles,M.A.,etal.(2013).2012Canadianguidelinesforthediagnosisandmanagementoffibromyalgiasyndrome:
execuOvesummary.PainResearchandManagement,18(3),119-126.2. Kayhan,F.,etal.(2016).SexualdysfuncOon,mood,anxiety,andpersonalitydisordersinfemalepaOentswithfibromyalgia.
NeuropsychiatricDiseaseandTreatment,12,349-355.3. Rico-Villademoros,F.,etal.(2012).SexualfuncOoninginwomenandmenwithfibromyalgia.JournalofSexualMedicine,9,
542-549.4. Byers,E.S.,&Rehman,U.(2013).Sexualwell-being.InD.Tolman&L.Diamonds(Eds.),APAHandbookofsexualityand
psychology.Washington,DC:APABooks.5. Braun,V.,&Clarke,V.(2006).UsingthemaOcanalysisinpsychology.Qualita1veResearchinPsychology,3,77-101.
ACKNOWLEDGEMENTS• Fundingsupport:BanOngPostdoctoralFellowship(P.Santos-Iglesias),UNBResearchFunds(D.LaChapelle&E.S.Byers)• Resourcesupport:UNBPsychologicalWellnessCentre*ForacopyofthisposterpleasevisithOp://www.rehabilita8onpsychologyresearchlab.com
ENGAGEMENTINSEXDESPITEFM
VALUESEX
LITTLETONOENGAGEMENTINSEX
DONOTVALUESEX
4.Highdistress/conflict 3.Lowdistress/conflict
1.Lowdistress/conflict 2.Highdistress/conflict
“SomeOmesifI’mhavingareallybaddayImightjusthavetotellhim‘Hey,mykneehurts,we’renotgonnahavesexinthatposiOon,let’sdoitthisway’andit’sreallyanon-issue…there’sneveranyconflictaboutit.”–ParOcipant4“RightnowI’mnotconcerned[aboutoursexlife]…we’reinagoodplaceIthink…smoothsailing.”–ParOcipant8
“Thepaindoesn’tpreventme[fromhavingsex].Sexisworththepain.”-ParOcipant12“EvenifIdon’tfeellike[sex]IsOlldoit…SexispartofyourrelaOonshipandyouhavetotrythebestthatyoucantohaveagoodsexuallifewithyourpartner…”–ParOcipant18
• AproporOonofwomenwithFMarewillingtoengageinsexualacOvitydespitetheircondiOon,indicaOngthatforsomewomen,sexisworththepain.• WomenwhoexperienceFM-relatedchangestotheirsexuallivesdonotnecessarilyexperiencepersonaldistressorinterpersonalconflictiftheirsexualbehaviourisconsistentwiththeirsexualvalues.• ClinicianscanhelpindividualsandcouplesadjusttoFMbyencouragingpaOentstoclarifytheirsexualvaluesand,ifsexisastronglyheldvalue,assisttheminfindingwaystoengageinsexualacOvitydespiteFM(e.g.,
communicaOontraining,recommendingchangestothesexualscript).• EngagementinvaluedacOviOesdespitepainisanessenOalcomponentofchronicpainacceptance,thereforeawoman’swillingnesstoengageinsexualacOvitydespiteFMmaybeanindicatorofmoregeneralchronic
painacceptance.
“Iwouldgetangryandfrustrated[whenFMgotinthewayofsex].It’slikeFMhasaffectedsomanyaspectsofmylife,can’tIjusthaveonethingthatitdoesn’taffect….”–ParOcipant13“IfeellikeI’velet[myhusband]down”–ParOcipant7
“[Oursexlife]lackswhenIhaveaperiodofreallynotfeelingwell.Ijustkeeptellingmyself‘I’mgoingtofeelbeaerinafewdays’…,butrightnowithasn’tgoaenanybeaerandwesOllaren’thavingsex.”–ParOcipant11
“LotsofOmeyoudon’tfeellikebeingtouched.Especiallywhenyouhaveaflare-up…Sexisthelastthingonyourmindforsure.Withus[lackofsex]isnottoobad…Icouldseeothercouples,itimpacOngthemforsure…fighOngaboutitorwhateverbutwe’vebeenveryfortunate...Thetwoofusareokaywiththat.”–ParOcipant1
“IknowthatifIhave[sex]morefrequentlyI’mgoingtobeinagony,soIjustdon’t...Iwon’tevenentertainthethought[ofhavingsex]evenifIamaroused.”–ParOcipant5“Although[sex]isenjoyableforbothofus,it’snotasimportant[tous]asitmaybeforsomepeople.”–ParOcipant14
“[Myhusband]wouldmakemeliterallycryatnightsaying‘youknowhowimportantsexistome’and‘youknowthatwaspartofthedealwhenwegotmarried’and‘nowyou’rejustpretendingthatyoucan’t[havesex]anymorebecauseyourlosinginterest’…soIwouldsufferthroughit.”–ParOcipant9
IMPLICATIONS