How Many Young Women Suffer Sexual Pain?

About half. That’s the proportion of women in their twenties who say they’ve suffered chronic pelvic pain—extended genital area, sex-related distress, not caused by menstrual cramps, pregnancy, childbirth, injuries, or illness. That proportion is considerably higher than previous estimates and much higher than most people would guess. What’s going on? A recent study offers new insights.

The Study

Researchers at several universities analyzed data from a large ongoing project, the Growing Up Today Study (GUTS), a huge Harvard-sponsored effort launched in 1996. The recent report focused on 6,150 young American women, with an average age of 23. Almost half said they had suffered pelvic pain, and for 90 percent of them, it lasted longer than six months.

Previous studies have shown that pelvic pain impacts 6 to 31 percent of women of all ages. This study shows a much higher prevalence—at least in young adult women.

Why so much pain in young women? That’s not entirely clear. But many young men are uninformed about women’s sexuality. And most young women are sexually inexperienced and don’t alert their partners to their suffering.

A study by an international team of researchers supports this. It involved 382 women who’d reported sexual pain during the previous year. Only half (51 percent) ever mentioned it to their partners. They were most likely to speak up if their pain felt severe, but 82 percent said theirs was “only” mild-to-moderate. Meanwhile, even mild pain significantly interfered with the women’s erotic pleasure. Why didn’t they speak up? Most said sex is more for men’s pleasure than theirs.

This “pleasure gap” is especially true for young women. By middle age, after decades of sexual experience, many women become more erotically assertive. But young adult women typically make love with young adult men who may not understand that sexual pain is even possible for women let alone common.

The Sexual Preference Connection

Previous studies have ignored sexual pain’s association with sexual orientation. The recent GUTS-based report revealed that the two are linked:

• No partner sex: 34 percent reported chronic pelvic pain.

• Lesbians: 36 percent.

• Heterosexual women: 44 percent

• Bisexual women: 55 percent

It makes sense that compared with lesbians, heterosexual women would be at higher risk. Few men, especially young men, know much about women’s bodies or erotic pleasure. Women do.

But it’s a mystery why bisexual women would be at greatest risk for pain. Perhaps it’s our either/or sexual culture. Either straight or gay/lesbian. Many bisexuals feel comparatively ostracized, isolated, and stressed, all of which may intensify pain.

Lovemaking Torpedoed

Italian researchers asked 1,034 women aged 18 to 40 if they experienced pain during partner lovemaking. One-third (31 percent) said yes. Compared with women free of sex-related pain, they reported:

• More sexual distress.

• More anxiety.

• Poorer sexual function.

• Poorer mental health.

• Less sexual desire.

• Greater aversion lovemaking.

• Less sexual satisfaction.

• More psychological negativity.

• And poorer quality of life.

Women’s sexual pain becomes its own little circle of hell. Which is terrible for sex.

Many Possible Causes

Sexual pain has many possible causes:

• Relationship turmoil. When couples fight, and resentments fester, women may experience sexual pain. Consider sex therapy.

• Birth control pills. The pill increases the body’s release of compounds that may contribute to pain. If you experience sexual pain and take the pill, consider switching contraceptives. After quitting, it may take up to six months for pill-related pain to subside.

Sex Essential Reads

How Often Do Happy Couples Have Sex?

Virginity Loss: Not a Single Event, a Multi-Year Process

• Lovemaking issues. Men who rush into intercourse may cause women pain. Poorly lubricated intercourse can do the same.

• Gynecological issues. Several medical conditions cause or contribute to sexual pain. Fortunately, almost all can be resolved. Ladies, if you suffer pain, consult your primary care physician, gynecologist, or sexual medicine specialist.

Gentlemen, accompany your partner to doctor visits. She’s likely to appreciate the support, and the physician may be able to explain things to you better than your partner can. Some possibilities:

• ​​​Imperforate hymen. At birth, a thin membrane, the hymen, partially covers girls’ vaginas. It usually wears away during childhood, but in some women, residual hymen tissue may cause pain.
• Vaginismus. Around 10 percent of women suffer muscle spasms that constrict the vaginal opening or clamp it shut, making any insertions painful or impossible.
• Infections. Chlamydia, yeast, bacterial infections (vaginosis), genital warts, and pelvic inflammatory disease may cause pain during intercourse.
• Menopause. After 40, vaginal dryness and tissue thinning (atrophy) become increasingly prevalent. They may make intercourse uncomfortable or painful, even with lube.
• Vulvar skin conditions. Women’s genitals may become irritated by douching, shaving, latex allergy, or reactions to perfumed soaps, bubble baths, feminine hygiene products, or underwear made from synthetics.
• Oxalate irritation. Many foods contain these compounds, including spinach, almonds, cashews, beets, and chocolate. Women sensitive to oxalates may suffer sexual pain.
• More. Pain might also result from uterine prolapse, endometriosis, interstitial cystitis, irritable bowel syndrome, gynecological cancers, and other conditions.

Ask

Couples should discuss all aspects of their lovemaking, including any pain (Men can suffer sexual pain, too.) Speak up. And ask.

For more on women’s sexual pain, see the chapter in my recent book.