title: Painful intercourse is significantly associated with evoked pain perception and cognitive aspects of pain in women with pelvic pain.
abstract: BACKGROUND
  Evidence suggests that painful intercourse, pain-related psychosocial factors, and altered pain processing magnify the pain experience, but it is not clear how these factors are related to each other.
  
  
  OBJECTIVE
  The aims were to (i) characterize differences between women with pelvic pain and pain-free women using a battery of pain-related psychosocial measures, clinical pain ratings, and evoked local and remote pain sensitivity; and (ii) examine the relationship between intercourse pain, clinical pain, and local and remote evoked pain sensitivity.
  
  
  METHODS
  Women with pelvic pain lasting at least 3 months and pain-free women completed questionnaires and underwent pain sensitivity testing. Self-report measures included clinical pain intensity, pain catastrophizing, pain-related fear, pain anxiety, depression, sexual function, and self-efficacy. Pain sensitivity measures included threshold and tolerance and temporal summation of pain. Separate analyses of variance (anova) were used to test group differences in self-report and pain sensitivity measures. Correlations were calculated among dyspareunia, psychosocial factors, and evoked pain.
  
  
  METHODS
  Self-reported pain and pain sensitivity measures.
  
  
  RESULTS
  Twenty-eight pain-free women and 14 women with pelvic pain participated in this study. Women with pelvic pain reported greater pain intensity and greater psychosocial involvement compared with pain-free women. No differences existed between groups for thermal or pressure measures, but women with pelvic pain rated their pain with pain testing significantly higher than pain-free women. Intercourse pain was significantly associated with affective and sensory pain and pressure pain ratings at the puborectalis, vulvar vestibule, adductor longus tendons, and tibialis anterior muscle.
  
  
  CONCLUSIONS
  Differences in local pain ratings suggest that women with pelvic pain perceive stimuli in this region as more painful than pain-free women although the magnitude of stimuli does not differ. Alappattu MJ, George SZ, Robinson ME, Fillingim RB, Moawad N, LeBrun EW, and Bishop MD. Painful intercourse is significantly associated with evoked pain perception and cognitive aspects of pain in women with pelvic pain. Sex Med 2015;3:14-23.
authors.affiliation: Pain Research and Intervention Center of Excellence, University of Florida Gainesville, FL, USA ; Center for Pain Research and Behavioral Health, University of Florida Gainesville, FL, USA.
authors.forename: Meryl J
authors.initials: MJ
authors.lastname: Alappattu
authors.affiliation: Center for Pain Research and Behavioral Health, University of Florida Gainesville, FL, USA ; Department of Physical Therapy, University of Florida Gainesville, FL, USA.
authors.forename: Steven Z
authors.initials: SZ
authors.lastname: George
authors.affiliation: Center for Pain Research and Behavioral Health, University of Florida Gainesville, FL, USA ; Department of Clinical and Health Psychology, University of Florida Gainesville, FL, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Robinson
authors.affiliation: Pain Research and Intervention Center of Excellence, University of Florida Gainesville, FL, USA ; Department of Community Dentistry and Behavioral Science, University of Florida Gainesville, FL, USA.
authors.forename: Roger B
authors.initials: RB
authors.lastname: Fillingim
authors.affiliation: Department of Obstetrics and Gynecology, University of Florida Gainesville, FL, USA.
authors.forename: Nashat
authors.initials: N
authors.lastname: Moawad
authors.affiliation: Department of Obstetrics and Gynecology, University of Florida Gainesville, FL, USA.
authors.forename: Emily Weber
authors.initials: EW
authors.lastname: LeBrun
authors.affiliation: Center for Pain Research and Behavioral Health, University of Florida Gainesville, FL, USA ; Department of Physical Therapy, University of Florida Gainesville, FL, USA.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Bishop
keywords: Chronic Pelvic Pain; Dyspareunia; Quantitative Sensory Testing
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