Narratives on Sexuality in Vulvodynia and Endometriosis: A Qualitative Study on Italian Couples

Although qualitative research on dyspareunia has increased in recent years, most studies have focused on women's individual experiences or on specific difficulties within the couple, leaving underexplored how partners jointly construct the meanings of sexuality when pain becomes part of the relationship. Against this backdrop, this study explored how couples make sense of sexuality and how their interactional processes shape the relational patterns through which they navigate intimacy in the presence of pain. Drawing on episodic interviews with nine Italian heterosexual couples (M age = 34 years) affected by dyspareunia associated with vulvodynia and/or endometriosis, we conducted a reflexive thematic analysis through which four themes were co-constructed: "Between Body and Emotion: The Shifting Landscape of Sexuality"; "He Holds Back, She Consents: Silent Sacrifices"; "Together Alone: When Coping Is Delegated"; and "From Pain to Partnership: Reimagining Sexuality Together." Across narratives, couples described greater connection and intimacy when they were able to co-construct meanings and activate communicative spaces grounded in acknowledgment, mutual support, and negotiation. These findings underscore the importance of couple-centered clinical interventions that focus on interactive processes and promote reciprocity and a shared redefinition of sexuality. Adopting a relational and dialogical lens, the study highlights sexuality not as an individual function disrupted by pain, but as an evolving co-created process through which partners continually remake intimacy together.