Bond Julia C, Schildroth Samantha, White Katharine O, Fisher Rebecca, Pukall Caroline F, Abrams Jasmine, Wise Lauren A
Department of Obstetrics and Gynecology, Boston Medical Center, One Boston Medical Center Place, Boston, MA 02118, United States.
Department of Community Health Sciences, Boston University School of Public Health, Boston, MA 02118, United States.
J Sex Med. 2025 Jun 29;22(7):1173-1183. doi: 10.1093/jsxmed/qdaf100.
Despite the fact that painful intercourse is common among reproductive-aged females, little research has evaluated how people manage painful intercourse while trying to conceive.
To characterize the self-reported frequency and effectiveness of various self-management strategies among a population of pregnancy planners reporting painful intercourse in the past 4 weeks.
We used cross-sectional data from Pregnancy Study Online, an online preconception cohort study of pregnancy planners. Female-identified participants completed a baseline questionnaire that included questions about demographic, medical, and reproductive factors. Participants additionally completed an optional questionnaire asking about sexual function. We used a single question from the Female Sexual Function Index to evaluate painful intercourse: "Over the past 4 weeks, how often did you experience discomfort or pain during vaginal penetration (intercourse)?," with responses captured on a Likert scale from "Almost never or never" to "Almost always or always." Those who reported pain more frequently than "Almost never or never" were categorized as experiencing "any pain" with intercourse and completed additional questions about how they mitigated it. For each endorsed strategy, participants ranked how effective it was at improving pain on a Likert scale from "Never effective" to "Always effective." For analyses, we grouped "often" and "always" effective into a single category. We described the reported effectiveness of self-management strategies.
The prevalence of participants reporting a strategy as being "often" or "always" effective at improving pain.
In our sample of 2855 pregnancy planners, 855 (30.7%) reported any painful intercourse in the past 4 weeks. The most commonly tried pain management strategy was trying a different sex position (66.6% of participants), while the least common strategy was not allowing full penetration of the penis (29.9%). Lubricant was most effective, with 74.3% of participants reporting that it was "often or always" effective. The least effective strategy was finishing intercourse quickly, with only 32.5% of attempters reporting it was "often or always" effective.
Providers should be aware of strategies to improve painful intercourse to aid in patient counseling, both in the preconception period and more broadly when pursuing the diagnosis of, and medical management strategies for, dyspareunia.
Large geographic heterogeneity and low data missingness. Limitations include potential for misclassification and the use of non-validated self-report measures.
In a population of females trying to conceive, lubricant use and changing sex positions were frequently reported as "often or always" effective at improving painful intercourse.
尽管性交疼痛在育龄女性中很常见，但很少有研究评估人们在尝试受孕时如何应对性交疼痛。
描述在过去4周内报告有性交疼痛的备孕人群中，各种自我管理策略的自我报告频率和有效性。
我们使用了来自在线孕前队列研究“妊娠在线研究”的横断面数据。女性参与者完成了一份基线问卷，其中包括有关人口统计学、医学和生殖因素的问题。参与者还完成了一份关于性功能的可选问卷。我们使用女性性功能指数中的一个问题来评估性交疼痛：“在过去4周内，你在阴道插入（性交）时多久会感到不适或疼痛？”，回答采用李克特量表，从“几乎从不或从不”到“几乎总是或总是”。那些报告疼痛频率高于“几乎从不或从不”的人被归类为性交时经历“任何疼痛”，并完成了关于他们如何缓解疼痛的其他问题。对于每种认可的策略，参与者根据从“从不有效”到“总是有效”的李克特量表对其改善疼痛的效果进行排名。在分析中，我们将“经常”和“总是”有效的策略归为一类。我们描述了自我管理策略报告的有效性。
将一种策略报告为在改善疼痛方面“经常”或“总是”有效的参与者比例。
在我们的2855名备孕者样本中，855人（30.7%）报告在过去4周内有任何性交疼痛。最常尝试的疼痛管理策略是尝试不同的性交姿势（66.6%的参与者），而最不常见的策略是不允许阴茎完全插入（29.9%）。润滑剂最有效，74.3%的参与者报告它“经常或总是”有效。最无效的策略是快速结束性交，只有32.5%的尝试者报告它“经常或总是”有效。
医疗服务提供者应了解改善性交疼痛的策略，以便在孕前咨询中提供帮助，更广泛地说，在诊断性交困难和制定治疗策略时也能提供帮助。
地理异质性大，数据缺失率低。局限性包括可能存在错误分类以及使用未经验证的自我报告测量方法。
在试图受孕的女性人群中，使用润滑剂和改变性交姿势经常被报告为在改善性交疼痛方面“经常或总是”有效。
