Meana M, Binik Y M, Khalife S, Cohen D R
Department of Psychology, McGill University, Montreal, Quebec, Canada.
Obstet Gynecol. 1997 Oct;90(4 Pt 1):583-9. doi: 10.1016/s0029-7844(98)80136-1.
To compare biopsychologic profiles of women with dyspareunia with a matched no-pain control sample, and to determine whether dyspareunia subtypes based on physical findings have different psychosocial profiles from matched controls.
One hundred and five women with dyspareunia and 105 matched no-pain control women underwent standard gynecologic examination, endovaginal ultrasound, and colposcopy. They also completed a structured interview inquiring about pain other than dyspareunia, sexual function, and history of abuse, the Brief Symptom Inventory, the Sexual Opinion Survey, and the Locke-Wallace Marital Adjustment Scale.
In comparison with women who do not experience pain with intercourse, the dyspareunia sample was found to have more physical pathology on examination, and they reported more psychologic symptomatology, more negative attitudes toward sexuality, higher levels of impairment in sexual function, and lower levels of marital adjustment. They did not report more current or past physical or sexual abuse. However, when the undifferentiated dyspareunia sample was divided into subtypes based on physical findings from the gynecologic examinations, the pattern of significant differences from controls varied according to dyspareunia subtype. Elevated psychologic symptomatology and relationship maladjustment were confined to the subtype with no discernible physical findings who reported levels of sexual function not significantly different from matched controls. The vulvar vestibulitis subtype suffered the highest levels of sexual impairment, although this subtype was not characterized by higher levels of psychologic symptoms than controls.
As an undifferentiated group, women with dyspareunia have more physical pathology, psychologic distress, sexual dysfunction, and relationship problems. However, this pattern of differences appears to vary depending on the presence and type of physical findings evident on examination. Dyspareunia is a heterogeneous disorder requiring comprehensive gynecologic and psychosocial assessment to determine differentiated treatment strategies.
比较性交疼痛女性与匹配的无疼痛对照样本的生物心理特征，并确定基于体格检查结果的性交疼痛亚型与匹配对照在心理社会特征上是否存在差异。
105名性交疼痛女性和105名匹配的无疼痛对照女性接受了标准妇科检查、经阴道超声检查和阴道镜检查。她们还完成了一项结构化访谈，询问除性交疼痛外的其他疼痛、性功能和虐待史、简明症状量表、性观念调查以及洛克-华莱士婚姻调适量表。
与性交时无疼痛的女性相比，性交疼痛样本在检查中发现有更多的身体病理状况，并且她们报告有更多的心理症状、对性的更消极态度、更高水平的性功能障碍以及更低水平的婚姻调适。她们没有报告更多当前或过去的身体或性虐待情况。然而，当根据妇科检查的体格检查结果将未分化的性交疼痛样本分为不同亚型时，与对照组的显著差异模式因性交疼痛亚型而异。心理症状和关系失调的增加仅限于没有明显体格检查结果的亚型，该亚型报告的性功能水平与匹配对照组无显著差异。外阴前庭炎亚型性功能受损程度最高，尽管该亚型的心理症状水平并不高于对照组。
作为一个未分化的群体，性交疼痛女性有更多的身体病理状况、心理困扰、性功能障碍和关系问题。然而，这种差异模式似乎因检查中明显的体格检查结果的存在和类型而异。性交疼痛是一种异质性疾病，需要进行全面的妇科和心理社会评估以确定不同的治疗策略。
