A new study published in BJOG: An International Journal of Obstetrics and Gynaecology is shedding light on what its authors call a "neglected female health problem." The research, published this week, reveals that nearly one in 10 British women ranging in ages from 16 to 74 experience dyspareunia, or painful sex.
"Although painful sex is less commonly reported by women than lacking interest in sex and difficulty reaching climax, it is the sexual function problem most commonly experienced as distressing," the study's authors write. "It can lead to feelings of isolation, shame, sexual inadequacy, loss of confidence and feeling out of control."
Researchers in the UK pulled data from the third edition of the National Survey of Sexual Attitudes and Lifestyles, which included the responses of 6,669 women who were sexually active and living in Britain between September 2010 and August 2012. Participants were asked to share details about their sex life: specifically, any symptoms that lasted more than three months, including whether they'd experienced physical pain, lack of interest, excitement or enjoyment, anxiety, the inability to orgasm, an orgasm that came too quickly, or uncomfortable vaginal dryness. Those who said they'd had painful sex were also asked to share how long they'd experienced this and how they felt about it, while women who said they had not been sexually active in the last year were asked to share if they'd avoided intercourse because of fear of pain.
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The study's authors found that of the sample, 7.5 percent reported painful sex for three months or more; 4.6 percent reported pain during sex for six months or more in the last year, which left half of them distressed. While women between the ages of 55 and 64 were most likely to report pain during intercourse, they were followed closely by younger women between the ages of 16 and 24.
Kirstin Mitchell, a senior research fellow at the University of Glasgow and lead author on the study, says there are a number of explanations for why younger women may experience painful sex. "Some may have an underlying medical condition or infection," she tells Broadly. "For some, it may be that they do not feel confident or empowered to communicate to a partner what they like and dislike, and so they end up doing sexual activities that they don't really enjoy—this then means they are not properly aroused and this can make sex painful. Others may feel anxious and tense up, causing sex to be painful, and this can lead to further anxiety in anticipation of pain."
Not surprisingly, many women (62 percent) who reported painful sex also reported a lack of interest, and almost half said they had avoided intercourse in the past year because of sexual difficulties. Among the examples of sexual difficulties was fear: "Among women aged 16–74 years, 1,708 were not sexually active in the last year and answered the item on avoidance of sex because of sexual difficulties," the study notes. "Of these, 211 (12.35%) reported avoiding sex, with 35 reporting pain, or fear of feeling pain, as a reason for avoidance."
Avoiding sex could place stress on the relationship, depending on how each individual feels about it, Mitchell says. "Interestingly, we did not see an association between painful sex and happiness with relationship, though painful sex does co-exist with difficulties with sexual aspects of the relationship, such as not sharing same sexual likes and dislikes."
In terms of the research's practical recommendations, the study suggests painful sex might be taken into consideration as a symptom to help diagnose other health problems in women, much in the same way as erectile dysfunction is often an early sign of heart disease in men. "For women experiencing painful sex," Mitchell says, "they should seek professional help to investigate possible underlying medical conditions."
According to the study, "[o]nly a fraction of women affected by genital pain disorders ever receive an official diagnosis." Mitchell says research into dyspareunia has historically been neglected because "underlying conditions are difficult to diagnose and treat, and the causes are complex and poorly understood. And also because there is little funding for research and treatment of sexual function problems in general."