Painful sex (dyspareunia) in women: prevalence and associated factors in a British population probability survey

Objective: To estimate the prevalence of painful sex among women in Britain, and to explore associated sexual, relationship and health factors that should be considered in assessment. Design: Multi-stage, clustered and stratified population probability sample survey, using computer-assisted self-interview. Sample frame was the British Postcode Address File. Setting: Participants interviewed at home between 2010 and 2012. Sample: A total of 15 162 adults aged 16–74 years (8869 women). Data reported from 6669 sexually active women. Methods: Age-adjusted logistic regressions to examine associations between painful sex and indicators of sexual, relational, mental and physical health. Main outcome measure Physical pain as a result of sex for ≥3 months in the past year, plus measures of symptom severity. Results: Painful sex was reported by 7.5% (95% CI 6.7–8.3) of sexually active women, of whom one-quarter experienced symptoms very often or always, for ≥6 months, and causing distress. Reporting painful sex was strongly associated with other sexual function problems, notably vaginal dryness (age adjusted odds ratio 7.9; 6.17–10.12), anxiety about sex (6.34; 4.76–8.46) and lacking enjoyment in sex (6.12; 4.81–7.79). It was associated with sexual relationship factors [such as not sharing same level of interest in sex (2.56; 1.97–3.33)], as well as with adverse experiences such as non-volitional sex (2.17; 1.68–2.80). Associations were also found with measures of psychological and physical health, including depressive symptoms (1.68; 1.28–2.21). Conclusion: Painful sex is reported by a sizeable minority of women in Britain. Health professionals should be supported to undertake holistic assessment and treatment which takes account of the sexual, relationship and health context of symptoms