Psychosocial factors could be related to genito-pelvic pain/penetration disorder (GPPPD) in young American women, suggests a new Journal of Sexual Medicine study.

GPPPD refers to pain and difficulty with penetrative sex and includes dyspareunia and vaginismus.

In a group of 593 sexually active female college students, about 19% reported frequent sexual pain, occurring in at least half of their intercourse experiences. (For the purposes of the study, sexual intercourse was defined as “sexual contact between individuals that involves penetration, especially the insertion of a person’s erect penis into a person’s vagina.”

About a quarter of the women said they had occasional pain, ranging from 10% to 25% of their intercourse experiences.

The women, who were students in an introductory psychology course, completed a series of assessments during the 2019-2020 academic year. Their average age was 18.96 years, and all participants were heterosexual. About 41% were single, and 56% were in relationships. Roughly two-thirds had a regular sexual partner.

In the surveys, the women answered questions about pain, sexual function, and sexual distress. Other survey items addressed the women’s expectations of their first intercourse, their sexual education, the degrees of sexual guilt they felt, their beliefs about gender roles, their religion, and their religiosity.

The authors identified several factors that were associated with painful sex, including having a regular sexual partner, having less sexual activity, having more sexual distress, and being unable to reach orgasm.

Expectations about sex also played a role. Women who had been told that sex would be painful and who knew more people who had painful sex were more likely to have painful sex themselves.

Sex guilt was associated with painful intercourse as well, “indicating that internalized expectations of what constitutes acceptable and transgressive sexual conduct contribute to the manifestation of painful sex experiences.”

Religiosity did not appear to be related to painful sex. The authors suggested that women who are more religious or conservative might wait until they’re older to have sex or abstain from sex until marriage. Women in this situation might have been excluded from the study because they were not yet sexually active.

However, sex guilt mediated the relationship between religiosity and sexual pain, the authors said. “This indicates that it is not religiosity per se that increases painful sex but religiosity that causes sex guilt,” they wrote.

They noted several limitations to the research. As the study sample was, for the most part, young, heterosexual, white, and middle-class, the results would not necessarily apply to other groups of women. In addition, the self-report measures used may not be appropriate for college students, who tend to have more casual sex than steadily partnered women. They may also have sex less frequently.

The authors recommended that healthcare providers discuss sexual pain with their younger patients, helping them understand that painful sex can be treated and managed. Organizations that teach women about sex, such as churches and schools, could also help with this effort, they said.

Resources

• The Journal of Sexual Medicine - “Exploring Relationships Between Genito-Pelvic Pain/Penetration Disorder, Sex Guilt, and Religiosity Among College Women in the U.S.”
  Azim, Katharina A., PhD, et al.
  (Full-text. Published: March 20, 2021)
  https://www.jsm.jsexmed.org/article/S1743-6095(21)00244-7/fulltext