Healthcare professionals need more support in broaching the topic of dyspareunia – or painful sex – say researchers, who have found nearly one in 10 of UK women are experiencing it.
The findings come from the third National Survey of Sexual Attitudes and Lifestyles, which is the largest scientific study of sexual health lifestyles in Britain.
“Healthcare professionals should be supported in taking a detailed history”
The national survey examined 8,869 women aged between 16-74 from 2010 to 2012. Among the 6,669 who had been sexually active in the past year, 7.5% reported having painful sex.
Of those, 1.9% experienced morbid pain – symptoms lasting at least six months and occurring very often or always and leaving the woman feeling distressed.
The proportion who reported painful sex was highest in women aged 55-64 and those aged 16-24.
Of the 1,708 women who were not sexually active, 2% said they avoided intercourse due to painful sex or a fear of feeling pain.
The researchers found painful sex was strongly associated with other sexual function problems, in particular vaginal dryness, feeling anxious during sex, and lack of enjoyment in sex.
It was also linked to poor physical and mental health including depression, sexual relationship factors, such as not sharing the same level of interest in sex, and adverse experiences, such as a sexually transmitted infection diagnosis and non-volitional sex.
Of those who reported painful sex, 31% said they were dissatisfied with their sex life, compared to 10% of women who did not report painful sex, while those experiencing pain were more likely to say they had avoided sex in the past year because of sexually difficulties.
The study, published in BJOG: An International Journal of Obstetrics and Gynaecology, was carried out by the London School of Hygiene and Tropical Medicine, University College London and NatCen Social Research.
“Sex is more likely to be painful at the extremes of reproductive life”
Lead study author Dr Kirstin Mitchell said: “While dyspareunia is a common problem, sexual pain disorders are often overlooked because underlying conditions are often difficult to diagnose and treat, and causes can be complex and poorly understood.
“This data demonstrates the importance of taking a holistic approach to medical care which takes into account the sexual, relationship and health context of symptoms,” she said.
“Healthcare professionals should be supported in taking a detailed history during a patient’s clinical assessment; thoroughly investigating symptoms, asking about enjoyment and satisfaction, and considering the relationship context,” said Dr Mitchell.
“There is also a need for resources to support clinicians who feel uncomfortable broaching the topic of sexual function and pleasure with patients, including advice on language and on when to refer patients to specialists in sexual health,” she added.
Edward Morris, vice president of the Royal College of Obstetricians and Gynaecologists, said: “This study raises the need for increased awareness that sex is more likely to be painful at the extremes of reproductive life – in young women and those who have gone through the menopause.
“It also reveals an association between painful sex and women wanting to have known more at first sexual experience,” he said.
“Given that painful sex is common in younger women, and that half of young women report their first experience of intercourse as painful, it would be beneficial to ensure that the possibility of pain is discussed openly in sex education and in consultations between young people and health professionals,” he added.