Visual Attention to Erotic Images in Women Reporting Pain with Intercourse

The coupling of sex and pain that characterizes dyspareunia creates an interesting theoretical conundrum of clinical significance: Are women with dyspareunia distracted from sexual stimuli (as the sexual dysfunction literature would suggest), or are they hypervigilant to sexual stimuli because they elicit thoughts and expectations of pain (as the literature would suggest)? The current study measured attention to sexual stimuli in 20 women reporting persistent pain with intercourse, 14 women reporting hypoactive sexual desire, and 20 no-dysfunction control women. Participants viewed a series of erotic images, each containing a semantically-inconsistent object, while an eye-tracker measured and recorded their eye movements. Women with pain looked less and fewer times at the sexual scene regions of the images than did both women with low sexual desire (p = .024, and p = .018, respectively) and the no-dysfunction control group (p < .001, and p = .003, respectively). Women with dyspareunia also looked at the context scene region significantly more times and for longer periods than did the no-dysfunction control women (p = .013, and p = .042, respectively). Results are interpreted to be potentially supportive of the cognitive distraction hypothesis associated with sexual dysfunction, with an additional component of cognitive avoidance of sexual stimuli for the women reporting sexual pain.