University at Buffalo, SUNY, Buffalo, NY, USA.
University of Memphis, Memphis, TN, USA.
J Sex Med. 2021 Apr;18(4):770-782. doi: 10.1016/j.jsxm.2021.02.003. Epub 2021 Mar 20.
Despite a growing body of research on psychosocial factors in Genito-Pelvic Pain/Penetration Disorder (GPPPD) during sexual intercourse, there are few studies examining adolescent and young adult women's experiences with painful sex and the effects of religiosity, sexual education, and sex guilt.
The purpose of the study was to examine the occurrence of GPPPD among sexually active female college students, including psychosocial factors of religiosity and religious practice, sexual education, sex guilt, and sexual distress.
Data were collected from 974 college women from a university in the Northeastern U.S. We limited our sample to sexually active women (n = 593, 60.9%; mean age: 18.96) who responded to the questionnaire item, "In general, do you feel pain with sexual intercourse?" Participants completed the Female Sexual Function Index (FSFI), Female Sexual Distress Scale (FSDS), Revised Mosher Sex Guilt Scale, Abbreviated Santa Clara Strength of Religious Faith Questionnaire, 10-item Gender Role Beliefs Scale, and measures on sexual wellness and practice and sexual education experiences. Data were analyzed using standard bivariate and regression analyses as well as path analysis.
Women were asked, "In general, do you feel pain with sexual intercourse?" and categorized into one of three pain groups: occasional (10%-25% of the time), frequent (50% or more), and no pain (less than 10%).
GPPPD with sex was prevalent among young college women, with 113 (19.1%) reporting frequent pain and 143 (24.1%) occasional pain (control n = 337, 56.8%). Numerous statistically significant factors were identified, including frequency of sex, ability to orgasm, sensations during intercourse, presence of a steady sexual partner, expectations of painful sex, sex guilt, and sexual distress. Sex guilt acted as full mediator between religiosity and painful sex.
Healthcare providers should proactively initiate conversations with young female patients about painful intercourse to identify issues and normalize language on pain with sex. Educators are urged to teach evidence-based information on pain-free and guilt-free sexual experiences inside and outside religious contexts.
Painful sex affects adolescent and young adult women at a similar rate as non-college adult women and while religiosity does not directly impact young women's GPPPD, religiosity does lead to painful sex if it causes sex guilt. Further research is needed into the mechanisms of religion-based sexual shaming and among religiously conservative women who practice abstinence until marriage. Azim KA, Happel-Parkins A, Moses A, et al. Exploring Relationships Between Genito-Pelvic Pain/Penetration Disorder, Sex Guilt, and Religiosity Among College Women in the U.S. J Sex Med 2021;18:770-782.
尽管越来越多的研究关注性传播疾病中的社会心理因素，但很少有研究探讨青少年和年轻女性在疼痛性性行为方面的经历以及宗教信仰、性教育和性内疚的影响。
本研究旨在调查性活跃的女大学生中是否存在生殖道疼痛/插入障碍（GPPPD），包括宗教信仰和宗教实践、性教育、性内疚和性困扰等社会心理因素。
本研究的数据来自美国东北部一所大学的 974 名女大学生。我们将样本限制为有性活跃的女性（n=593，60.9%；平均年龄：18.96 岁），她们回答了问卷项目“一般来说，你在性交时感到疼痛吗？”参与者完成了女性性功能指数（FSFI）、女性性困扰量表（FSDS）、修订后的莫舍性内疚量表、缩写的圣克拉拉信仰问卷、10 项性别角色信念量表，以及关于性健康、实践和性教育经验的测量。使用标准的双变量和回归分析以及路径分析进行数据分析。
女性被问到“一般来说，你在性交时感到疼痛吗？”并分为三组：偶尔（10%-25%的时间）、经常（50%或更多）和无疼痛（少于 10%）。
年轻女大学生中普遍存在生殖道疼痛/插入障碍，113 名（19.1%）报告经常疼痛，143 名（24.1%）报告偶尔疼痛（对照组 n=337，56.8%）。确定了许多具有统计学意义的因素，包括性频率、性高潮能力、性交时的感觉、稳定的性伴侣存在、对疼痛性性的预期、性内疚和性困扰。性内疚作为宗教与疼痛性性之间的完全中介因素。
医疗保健提供者应主动与年轻女患者就疼痛性性交进行交谈，以识别问题并使与性疼痛相关的语言正常化。教育工作者被敦促在宗教和非宗教背景下教授关于无痛苦和无内疚的性体验的循证信息。
疼痛性性交在青少年和年轻成年女性中的发生率与非大学生成年女性相似，虽然宗教信仰不会直接影响年轻女性的 GPPPD，但如果宗教信仰导致性内疚，它确实会导致疼痛性性。需要进一步研究基于宗教的性羞耻的机制，以及在宗教保守的、实行婚前禁欲的女性中。
