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ORIGINAL RESEARCH—PAIN: Sexual Functioning in Women with Chronic Pelvic Pain: The Role of Anxiety and Depression


Moniek ter Kuile, PhD, Department of Gynecology and Sexology, Leiden University Medical Center, Poortgebouw-zuid (VRSP), PO Box 9600, Leiden, 2300 RC, The Netherlands. Tel: 0031715263121; Fax: +3171 526 6950; E-mail:


Introduction.  Chronic pelvic pain (CPP) in women is a long lasting and often disabling condition. It seems reasonable to expect that as a result of the pain, extreme fatigue and/or emotional problems, women with CPP may report a variety of sexual problems.

Aim.  The present study investigated differences in the report of sexual problems in women with CPP compared with healthy controls, and whether the association of CPP with sexual problems was moderated or mediated by somatic and psychological factors as manifested in women suffering from CPP.

Method.  One hundred fifty-four women with CPP and 58 age-matched controls completed self-report measures for sexual functioning, pain, physical impairment, anxiety, depression, and sexual and physical abuse.

Main Outcome Measure.  Golombok Rust Inventory of Sexual Satisfaction.

Results.  Women with CPP reported higher levels of vaginistic complaints, sexual avoidance, nonsensuality and sexual dissatisfaction than healthy controls. Sexual problems were associated with anxiety, depression, and sexual abuse history but not with somatic factors as pain and physical impairment. Anxiety as well as depression, irrespective of the report of sexual abuse experiences, mediated the effect of CPP on sexual problems. Sexual abuse was a general predictor of sexual problems in both women with CPP and controls.

Conclusions.  Anxiety and depression constitute important factors in the evaluation of sexual problems in women with CPP. ter Kuile MM, Weijenborg PTM, and Spinhoven P. Sexual functioning in women with chronic pelvic pain: The role of anxiety and depression. J Sex Med 2010;7:1901–1910.