629: Key Concepts for Female Sexual Pain: Integrating evidence, patient and health experts� perspectives

Topic: Education, Societal Impact, and Others
Subtopic: Education of pain care

Background and Aims: Female Sexual Dysfunction (FSD), particularly Genito-Pelvic Pain/Penetration Disorder, is a prevalent condition that negatively affects sexual function, well-being and quality of life.¹⁻³ Despite its impact, it remains underdiagnosed and inadequately managed.⁴ ⁵ Pain Neuroscience Education (PNE) has been shown to improve pain-related beliefs and outcomes, including in sexual dysfunction.⁶⁻¹⁰ Educational materials can further enhance knowledge, treatment engagement and clinical outcomes.¹¹ ¹² However, there is a lack of educational resources specifically addressing female sexual pain.¹³ Integrating evidence, women’s perspectives and healthcare professionals’ input has been recommended to support the development of relevant and effective educational content.¹⁴⁻¹⁷ Therefore, this study aimed to identify and integrate key educational concepts for female sexual pain using a multi-source approach.

Methods: A multi-phase study was conducted. Phase 1 consisted of a scoping review conducted in accordance with the Joanna Briggs Institute recommendations¹⁸ and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews¹⁹. The review aimed to identify educational content used in interventions for women with sexual pain. A comprehensive search strategy was applied across six electronic databases (MEDLINE, EMBASE, SCOPUS, PEDro, CINAHL and Cochrane Library). Phase 2 involved a qualitative study with women experiencing sexual pain. Semi-structured interviews were conducted to explore educational content and delivery formats, following the Consolidated Criteria for Reporting Qualitative Research²⁰. Phase 3 consisted of an online survey with healthcare experts in managing female sexual pain. Participants rated the importance of previously identified topics using a numerical scale (0–10). Survey reporting followed the Checklist for Reporting Results of Internet E-Surveys.²¹ Findings from all phases were integrated into key educational concepts.

Results: The scoping review identified seven studies, with educational content consistently addressing biopsychosocial domains, including pain mechanisms, pelvic floor function, vulvovaginal health, sexual function and relaxation strategies, alongside psychoeducational components such as emotional regulation and self-management. In the qualitative phase, 31 women (27.3 ± 5.1 years; pain intensity 5.6 ± 2.6; FSFI 22.0 ± 5.8) described sexual pain as multifactorial and dynamic. Four themes emerged: foundations, characteristics, etiology and management. Participants reported normalization of pain and delays in care, highlighting the need for educational resources combining accurate information, practical guidance, emotional validation and communication support, preferably in accessible digital formats. In phase 3, 45 healthcare professionals (physiotherapists, physicians, psychologists, sex therapists and pharmacist) rated all domains as highly relevant (mean >7). Integration of findings resulted in key domains including biopsychosocial mechanisms, beliefs and myths, sexual function, urogynaecological health, pelvic floor function, treatment approaches, coping strategies, daily life impacts and partner-related aspects.

Conclusions: This study identified and integrated key educational concepts for female sexual pain by combining evidence from the literature, women’s perspectives and healthcare professionals’ input. Findings support a biopsychosocial understanding of sexual pain, emphasizing the need for educational interventions that address physical, psychological and relational dimensions. The resulting framework includes domains related to pain mechanisms, sexual and urogynaecological health, pelvic floor function, treatment approaches, coping strategies and partner-related aspects. Beyond evidence-based content, women highlighted the importance of practical guidance, validation and support for communication and self-management. The convergence across phases reinforces the relevance and comprehensiveness of these domains, providing a structured foundation for developing educational resources. Such interventions, particularly when delivered in accessible digital formats, may improve knowledge, engagement and clinical outcomes.

References: 1. American Psychiatric Association (APA). Diagnostic and statistical manual of mental disorders (DSM-5). 5th ed. Porto Alegre: Artmed; 2014.
2. Faubion SS, Rullo JE. Sexual dysfunction in women: a practical approach. Am Fam Physician. 2015;92(4):281–288.
3. Verbeek M, Hayward L. Pelvic floor dysfunction and its effect on quality of sexual life. Sex Med Rev. 2019;7(4):559–564.
4. Mann J, Shuster J, Moawad N. Attributes and barriers to care of pelvic pain in university women. J Minim Invasive Gynecol. 2013;20(6):811–818.
5. Leusink P, et al. Women’s appraisal of the management of vulvodynia by their general practitioner: a qualitative study. Fam Pract. 2019;36(6):791–796.
6. Kundu S, et al. Supporting and inhibiting factors when coping with endometriosis from the patients’ perspective. Geburtshilfe Frauenheilkd. 2015;75(5):462–469.
7. Lee Y. Patients’ perception and adherence to vaginal dilator therapy: a systematic review and synthesis employing symbolic interactionism. Patient Prefer Adherence. 2018;12:551–560.
8. Morin M, et al. Multimodal physical therapy versus topical lidocaine for provoked vestibulodynia: a multicenter, randomized trial. Am J Obstet Gynecol. 2021;224(2):189.e1–189.e12.
9. Reis F, et al. “A journey to learn about pain”: the development and validation of a comic book about pain neuroscience education for children. Braz J Phys Ther. 2022;26(1):100348.
10. Mardon AK, et al. “I wish I knew then what I know now”—pain science education concepts important for female persistent pelvic pain: a reflexive thematic analysis. Pain. 2024;165(9):1990–2001.
11. Liossi C, et al. The effectiveness of online pain resources for health professionals: a systematic review with subset meta-analysis of educational intervention studies. Pain. 2018;159(4):631–643.
12. Pontin JCB, et al. Positive effects of a pain education program on patients with chronic pain: observational study. BrJP. 2021;4:130–135.
13. Mitchell KR, et al. Painful sex in women. BJOG. 2017;124(11):1689–1697.
14. As-Sanie S, et al. Endometriosis research gaps. Am J Obstet Gynecol. 2019;221(2):86–94.
15. Lamvu G, et al. Chronic pelvic pain in women. JAMA. 2021;325(23):2381–2391.
16. Allaire C, et al. Management of chronic pelvic pain. J Obstet Gynaecol Can. 2024;46(1):102283.
17. Villegas-Echeverri JD, et al. FIGO–IPPS consensus statement. Int J Gynecol Obstet. 2025;169(3):1140–1145.
18. Leusink P, et al. Women’s appraisal of the management of vulvodynia by their general practitioner: a qualitative study. Fam Pract. 2019;36(6):791–796.
19. Tricco AC, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467–473.
20. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–357.
21. Eysenbach G. Improving the quality of Web surveys: the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). J Med Internet Res. 2004;6(3):e34.

Presenting Author: Andresa Aguiar dos Santos
Submitting Author: Andresa Aguiar

Senior Author: Mariana Arias Avila Vera

IASP 2026 Global Year theme of Neuropathic Pain: No

• Felipe José Jandre dos Reis: PhD - Physical Therapy Department, Instituto Federal do Rio de Janeiro (IFRJ), Rio de Janeiro, RJ, Brazil. Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
• Mariana Arias Avila Vera: PhD - Study Group on Chronic Pain (NEDoC), Laboratory of Research on Electrophysical Agents (LAREF), Physical Therapy Post-Graduate Program and Physical Therapy Department, Universidade Federal de São Carlos (UFSCar), São Carlos, Brazil.