UK survey finds around 1 in 13 women report pain dur...

"Nearly 1 in 10 British women [7.5%] finds sex painful, according to a big study," BBC News reports.

The study's results highlight the arguably neglected issue of pain during sex – dyspareunia – which some women may be too embarrassed to seek treatment for.

Researchers surveyed almost 7,000 sexually active women and found 7.5% reported pain during sex.

Painful sex was associated with physical factors like vaginal dryness, which can begin with the menopause, and psychological factors like anxiety about sex.

Sexual anxiety can trigger a condition called vaginismus, which causes the involuntary tightening of muscles around the vagina whenever penetration is attempted.

The researchers in this study suggest there is a need for resources to support clinicians who feel uncomfortable broaching the subject of sex with their patients.

If you're experiencing pain during sex, see your GP or go to a sexual health (genitourinary medicine, or GUM) clinic.

Dyspareunia tends to be the sort of problem that won't get better by itself, and could be the sign of an underlying problem like a sexually transmitted infection (STI), such as chlamydia.

Find out more about sexual health support services in your area.

Where did the story come from?

The study was carried out by researchers from a number of UK institutions, including the London School of Hygiene and Tropical Medicine, the University of Glasgow and University College London.

It was published in the peer-reviewed British Journal of Obstetrics and Gynaecology on an open access basis, so it's free to read online.

The study was funded by the Medical Research Council, the Wellcome Trust, the Economic and Social Research Council and the Department of Health.

One of the authors is a governor of the Wellcome Trust. No other conflicts of interest were reported.

The BBC News story was accurate, but if you wanted to be pedantic, 7.5% doesn't really correspond to "nearly 1 in 10 women".

What kind of research was this?

The study involved a cross-sectional analysis of a population survey being run in the UK, which aimed to estimate the prevalence of painful sex in women.

Cross-sectional surveys are good at determining the proportion of the population who have a given condition – painful sex – at a given time.

However, they cannot prove cause and effect, so you cannot say which factors – for example, loss of arousal or sexually transmitted infections (STIs) – are causing painful sex, only that certain factors seem to be associated with it.

What did the research involve?

The study included 6,669 sexually active women in the UK aged between 16 and 74 who took part in the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). The survey was completed online.

Women who were sexually active in the last year were asked if they had experienced painful sex for three or more months.

They were also asked if they experienced other difficulties with their sex life lasting three or more months, including:

lack of interest in sex
not enjoying sex
feeling anxious during sex
feeling no excitement or arousal during sex
not climaxing, or taking a long time to
not reaching a climax despite feeling excited or aroused
reaching climax quicker than they would have liked
having an uncomfortably dry vagina

The researchers adjusted for age and examined the associations between reporting physical pain during sex and other sexual problems, demographic and health factors, sexual behaviour, sexual relationships and attitudes to sex.

What were the basic results?

Painful sex lasting three or more months in the last year was reported by 7.5% (95% confidence interval [CI] 6.7% to 8.3%) of sexually active women.

A quarter of these women experienced symptoms very often or always for over six months, which caused them distress (1.9%, 95% CI 1.5% to 2.3%).

Women who reported painful sex were more likely to have other problems with sexual function compared with women who did not experience any pain:

45.2% reported having an uncomfortably dry vagina, compared with 10.4% of women who did not experience pain
21% reported feeling anxious during sex, compared with 4%
40% lacked enjoyment in sex, compared with 10%
31% felt dissatisfied with their sex life, compared with 10%
29% felt distressed or worried about their sex life, compared with 9%
62% lacked interest in having sex, compared with 32%
24% lacked arousal during sex, compared with 7%
40% had difficulty reaching climax, compared with 14%
45% avoided sex because of difficulties, compared with 11%

Painful sex was also associated with sexual relationship factors, such as not sharing the same level of interest in sex as a partner (adjusted odds ratio [aOR] 2.56, 95% CI 1.97 to 3.33).

The experience of pain was also associated with adverse sexual experiences, such as STI diagnosis (aOR 1.85, 95% CI 1.27 to 2.68).

How did the researchers interpret the results?

The authors concluded that their research provides "up-to-date prevalence estimates of painful sex in a representative sample of British women across a wide age range.

"It is also rare in exploring – simultaneously and in detail – associations between dyspareunia [painful sex] and sexual functioning of the relationship, previous sexual history, attitudes towards sex and general health."

They added that the findings have "addressed a gap in the understanding of the social and relationship patterning of painful sex (dyspareunia) at population level", and that their findings "are important and relevant to the work of a range of practitioners involved in gynaecology, oncology, psychosexual therapy, and more broadly in therapeutic settings".

Conclusion

Overall, the findings of this study indicate painful sex is experienced by around 1 in 13 sexually active women in the UK.

The findings also indicate there are a large number of factors, including relationships, health and attitudes toward sex, associated with painful sex.

The large number of women included in the study, and the adjustments made by researchers, mean the findings are broadly representative of the UK population aged between 16 and 74.

However, this study has a number of limitations:

The survey cannot prove painful sex was caused by the factors investigated, only that there was an association. It may be that the reverse is true in some cases – for example, painful sex causes anxiety or a lack of enjoyment during sex.
The data was self-reported and therefore may be subject to bias – for example, some women may not want to report pain during sex even if they do experience it, so the true prevalence is difficult to tell. Still, this could mean dyspareunia is actually more of a problem than reported in the study.

If you're experiencing pain during sex, it's best to get medical advice. It could be the sign of a physical problem that needs medical treatment, or a psychological issue that could benefit from counselling.

A good first step would be to make an appointment with your GP or local sexual health clinic.