A Descriptive and Longitudinal Analysis of Pain During Intercourse in Pregnancy

Abstract

Introduction: Pain during vaginal intercourse in pregnancy has largely been ignored despite physiological and psychological components of pregnancy that may be associated with its onset and persistence.

Aim: The current study aimed to determine the prevalence and the characteristics of clinically significant pain during intercourse in the second (18-24 weeks) and third (32-36 weeks) trimesters of pregnancy.

Methods: Pregnant women (N = 501) recruited from a local women's hospital completed an online survey in the second and third trimesters of their pregnancy regarding the presence, intensity, and characteristics of pain during intercourse. Women with clinically significant pain (ie, pain greater than or equal to 4 of 10 on a numerical rating scale) were grouped according to whether the pain was resolved, persistent, or new onset across the 2 pregnancy time points. Following guidelines outlined by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT), we conducted a descriptive analysis assessing the intensity and characteristics (eg, quality, onset, degree of improvement over time, and treatment strategies utilized) of clinically significant pain during intercourse.

Main outcome measure: The main outcome measures in this study were the prevalence, intensity, and characteristics of clinically significant pain during intercourse.

Results: Overall, 21% of pregnant women (106/501) reported clinically significant pain during intercourse. We found that 22% (N = 16/106) of women who had this pain at 20 weeks reported that it had resolved at 34 weeks, 33% (40/106) reported persistent pain at both time points, and 46% (50/106) reported new onset of pain during intercourse at 34 weeks. The majority of women across all pain groups reported that the pain began during pregnancy and remained at the same intensity. Most women reported not using any pain management strategies to cope with their pain.

Clinical implications: One in 5 women experienced clinically significant pain during intercourse in pregnancy, with the majority of women not seeking treatment.

Strengths & limitations: This study is the first to comprehensively assess and describe the prevalence and characteristics of clinically significant pain during intercourse across 2 time points in pregnancy using IMMPACT guidelines. Small sample sizes in our pain groups may limit the generalizability of pain characteristics.

Conclusion: Findings suggest that many pregnant women in this study experienced significant pain during intercourse in pregnancy. Understanding the characteristics of this pain may improve its identification by health care providers and inform better prevention and treatment recommendations. Rossi MA, Mooney KM, Binik YM, et al. A Descriptive and Longitudinal Analysis of Pain During Intercourse in Pregnancy. J Sex Med 2019;16:1966-1977.

Keywords: Dyspareunia; Pain During Intercourse; Pregnancy; Sexual Function.