Exploring Chronic Clitoral Pain: Cognitive-Affective Factors and Healthcare Experiences

Abstract

The clitoris may be the most important structure for sexual pleasure in individuals with clitorises; however, research on chronic clitoral pain remains a critical gap in the literature, resulting in clitoral pain being underdiagnosed and undertreated within the healthcare system. An initial descriptive study found that chronic clitoral pain can be a substantially distressing problem that impacts daily and sexual functioning. Still, there is a need for a greater understanding of the role of psychological (cognitive-affective) factors in outcomes associated with this condition. Additionally, literature on clitoral pain has exclusively considered heterosexual, cisgender women, neglecting the experience of sexual and gender minority individuals. The current study aimed to (1) further describe the characteristics of chronic clitoral pain (e.g., onset, duration, pattern) in a diverse sample of gender and sexual minority and majority individuals, (2) evaluate the association between psychological factors (pain catastrophizing, hypervigilance to pain, and fear and avoidance of pain) and outcomes (pain intensity and sexual function interference), and (3) describe the healthcare experiences of individuals with chronic clitoral pain and identify barriers to seeking healthcare. Participants were recruited for a more extensive online study on chronic genitopelvic pain. Of the larger sample, thirty participants reported experiencing clitoral pain and were included in analyses. Descriptive analyses illustrated substantial diversity regarding the onset, duration, and pain pattern. Multiple regression analyses indicated that pain catastrophizing was significantly associated with increased pain intensity and sexual function interference. A thematic analysis showed that barriers to seeking healthcare included a perceived lack of knowledge from healthcare providers and a feeling that pain would be dismissed or ignored. The current study contributes to a more nuanced understanding of the experiences of individuals with chronic clitoral pain.