Rossi Meghan A, Vermeir Ella, Brooks Melissa, Pierce Marianne, Pukall Caroline F, Rosen Natalie O
Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada.
Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
J Sex Med. 2022 Jan;19(1):116-131. doi: 10.1016/j.jsxm.2021.11.004. Epub 2021 Dec 6.
There is limited information about the physical indicators and biopsychosocial predictors of self-reported pain during intercourse and pain during a gynecological examination at 12- and 24-month following childbirth.
This longitudinal study aimed to (i) Compare the findings from gynecological exams at 12- and 24-month postpartum for women with minimal vs clinically significant pain during intercourse; (ii) Assess the biomedical and psychosocial correlates of self-reported pain during intercourse and the vestibular pain index (VPI) from the cotton-swab test at 12- and 24-month postpartum; (iii) Establish the relationship between self-reported pain during intercourse and the cotton-swab test.
Women (N = 97 at 12 months postpartum and N = 44 at 24-month postpartum) recruited from a local women's hospital completed online surveys in their first trimester of pregnancy and at 12- and 24-month postpartum to assess pain during intercourse and biopsychosocial variables. Those with clinically significant (pain ≥4/10 on a visual analogue scale) were matched with those reporting minimal pain (pain <3/10) and underwent a gynecological exam including a cotton-swab test. Descriptive analyses, multiple regressions, and bivariate correlations were conducted to address each of the study aims, respectively.
(i) Findings from the gynecological examination (ii) Numerical rating scale for the VPI; (iii) Visual analogue scale of pain during intercourse.
The majority of women in both pain groups had normal physical findings in the gynecological exam. Greater sexual distress and pain catastrophizing at 12- and 24-month postpartum were significantly associated with greater pain during intercourse at each time-point, respectively. Greater pain catastrophizing at 12 months postpartum was significantly associated with greater pain during the cotton-swab test at that time-point. Lower relationship satisfaction at 12 months postpartum was associated with greater VPI ratings at 24 months postpartum. Pain during intercourse and the VPI were moderately and positively correlated.
Addressing psychosocial variables may interrupt the maintenance of postpartum pain. Following an initial assessment, self-reported pain intensity may be a suitable proxy for repeated examinations.
STRENGTHS & LIMITATIONS: This study is the first to describe the physical findings and psychosocial predictors of pain during intercourse and the VPI at 12- and 24-month postpartum. The homogenous and small sample may limit generalizability.
There were no observable physical indicators of clinically significant postpartum pain during intercourse. Psychosocial variables were linked to women's greater postpartum pain during intercourse and VPI ratings. Rossi MA, Vermeir E, Brooks M, et al. Comparing Self-Reported Pain During Intercourse and Pain During a Standardized Gynecological Exam at 12- and 24-Month Postpartum. J Sex Med 2022;19:116-131.
关于产后12个月和24个月时性交时自我报告的疼痛以及妇科检查时的疼痛的身体指标和生物心理社会预测因素的信息有限。
这项纵向研究旨在（i）比较产后12个月和24个月时性交时疼痛最小与具有临床显著疼痛的女性的妇科检查结果；（ii）评估产后12个月和24个月时性交时自我报告的疼痛以及棉签试验前庭疼痛指数（VPI）的生物医学和心理社会相关性；（iii）建立性交时自我报告的疼痛与棉签试验之间的关系。
从当地一家妇女医院招募的女性（产后12个月时N = 97，产后24个月时N = 44）在怀孕的前三个月以及产后12个月和24个月完成在线调查，以评估性交时的疼痛和生物心理社会变量。将具有临床显著疼痛（视觉模拟量表上疼痛≥4/10）的女性与报告疼痛最小（疼痛<3/10）的女性进行匹配，并进行包括棉签试验在内的妇科检查。分别进行描述性分析、多元回归和双变量相关性分析以实现每个研究目的。
（i）妇科检查结果；（ii）VPI的数字评分量表；（iii）性交时疼痛的视觉模拟量表。
两个疼痛组中的大多数女性在妇科检查中身体检查结果正常。产后12个月和24个月时更大的性困扰和疼痛灾难化分别与每个时间点性交时更严重的疼痛显著相关。产后12个月时更大的疼痛灾难化与该时间点棉签试验时更严重的疼痛显著相关。产后12个月时较低的关系满意度与产后24个月时更高的VPI评分相关。性交时的疼痛与VPI呈中度正相关。
解决心理社会变量可能会中断产后疼痛的持续存在。在初步评估后，自我报告的疼痛强度可能是重复检查的合适替代指标。
本研究首次描述了产后12个月和24个月时性交时疼痛以及VPI的身体检查结果和心理社会预测因素。样本同质且小可能会限制普遍性。
性交时临床上显著的产后疼痛没有可观察到的身体指标。心理社会变量与女性产后性交时更严重的疼痛和VPI评分有关。罗西MA、韦尔米尔E、布鲁克斯M等。比较产后12个月和24个月时性交时自我报告的疼痛与标准化妇科检查时的疼痛。《性医学杂志》2022；19：116 - 131。
