University Of The West Of England Researcher Explains Men's Experience Of Women's Sexual Pain

Sex therapist Deborah Lovell explains men's concerns about their partner's sexual pain in heterosexual relationships.

Mark Travers, Ph.D.

By Mark Travers, Ph.D. | March 26, 2024

A recent study in the journal of Sexual and Relationship Therapy highlights marginalization of men and pain as a communication issue. Men view Female Sexual Pain (FSP) as a signal of an underlying problem, which makes them feel marginalized and powerless. They tend to prioritize emotional intimacy in their relationships and challenge traditional masculinity norms.

I recently spoke to lead author Deborah Lovell of the School of Social Sciences at the University of the West of England, a practitioner psychologist and clinical sexologist, to discuss men's experience and understanding of their partner's FSP and inform better support for men and couples navigating FSP.

How would you describe female sexual pain in an intimate relationship?

Female sexual pain (FSP), in the context of heterosex, refers to penile-vaginal intercourse (PVI) being painful for a woman. The medical term for painful PVI is dyspareunia, and it may have physical and psychological causes. The pain may be felt externally on the vulva or internally in the vagina, uterus, or pelvis.

What inspired your team to investigate the experiences of male partners regarding female sexual pain?

My clinical work inspired this research with a man who was married to a woman who suffered from lifelong vaginismus (involuntary muscle contractions of the vaginal muscles during penetration). They had never been able to have PVI during the decades of their marriage. His wife did not want to attend therapy, so I worked solely with him; he was the client.

This was the first time—for me—that the partner's experience was at the center of the work. In the sexual pain research, partner experiences have also been poorly attended to, despite frequent recommendations to include men. We felt this was an important aspect of the overall experience of FSP to address.

The study mentioned that men felt marginalized, particularly within medical settings. Can you elaborate?

The medical model takes an individual approach to any sexual difficulty and attends to organic pathology and parts of the body that may require "fixing." In the context of FSP, men do not, therefore, have a biological claim to patient status and become the "non-patient."

This study described feeling insignificant and invisible during interactions with medical professionals. This echoes men's experiences in other contexts, such as pregnancy and loss of a baby, where again, men are not recognized (by the medical system) as patients but nevertheless are highly involved in the issue for which their partner is receiving care.

They understood themselves as the "non-patient," which appeared to have broader implications as they also considered their own distress as insignificant. Although men suffered in many ways, they seemed to downplay their own struggles and consider themselves selfish if they drew attention to them.

What were some of the other effects on men?

FSP is a unique pain condition in that, for many women, is only experienced during sexual activity. In heterosex, this means it is the man's actions that trigger pain, and many men struggle with the notion of being a perpetrator or aggressor.

They appeared to move into more passive positions, no longer initiating sex and preferring to wait for their partner to do so. They were also tentative about even talking about sex or sexual pain, as pursuing conversations felt "pushy."

We were also interested in how men themselves make sense of FSP. It is poorly understood within the medical community. It can take months or years for women to receive an accurate diagnosis, leaving men to consider their own "theories" about why pain is present.

It appeared that in the absence of an "authoritative explanation," men considered that pain could signal that sex was not wanted and that the "problem" may lie in them and their own (lack of) desirability. Several men questioned their adequacy and self-esteem issues in the "pre-diagnosis" space.

How did the participants respond within the context of common beliefs about masculinity and sexuality?

A common belief of particular relevance to FSP is that PVI is fundamental to heterosex; it is "real" sex and the central objective of sexual interaction. Within this "coital imperative," men are considered to be unequivocally desiring penetrative sex.

Men in this study gave diverse accounts of the importance of PVI within their relationships. Some men upheld this belief—to an extent—and others conceptualized sex as involving many different possibilities, with PVI being of no particular importance. A few men spoke about how removing PVI from the couple's sexual repertoire offered them relief from the conventional expectations of sex.

What was consistent across the data was an "intimacy imperative" as these men all sought connection and closeness. This is at odds with another common belief that men's sexuality is physically oriented and driven by biological urges and that women's sexuality is emotional and relationship-centric.

What are your suggestions for couples who are navigating the challenges of female sexual pain in their relationship?

The findings I outlined in the previous question highlight the importance of not relying on commonly held beliefs about "what sex is"—although social discourse powerfully influences expectations of gender and sex, it does not dictate it.

It may be helpful for both members of the couple to explore the messages they have received about such expectations (from movies, magazines, friends and family, religion, sex education, and porn, for example) and the influence they have had, but then construct and define for themselves their own notions of sex.

Consider what are their own preferences, what practices they wish to include, what they want sex to mean for them, etc.

This research aimed to understand men's experiences as pain during PVI is an interpersonal experience and occurs within a partnership. This study has highlighted that female sexual pain is not just a woman's matter.

Both individuals are impacted (in different ways), as is the sexual and broader relationship that both members of the couple share. This may speak to the importance of help-seeking being a joint experience by, for example, discussing treatment options with each other, attending talk therapy together, and both being involved in searching for resources.

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