Dyspareunia in their own words: A comprehensive qualitative description of endometriosis-associated sexual pain

Kate Wahl, Shermeen Imtiaz, K.S. Joseph, Kelly B. Smith, Paul J. Yong, Susan Cox
In: medRxiv · 2019 · doi:10.1101/19005793 · W2972396157
preprint OA: green CC0
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Abstract

Background Dyspareunia is a classic symptom of endometriosis but is neglected in research and clinical contexts. This study explored the experience of this endometriosis-associated sexual pain. Methods This was a qualitative descriptive study that included people who had experienced endometriosis-associated dyspareunia alone or with a partner. Data collection involved semi- structured interviews with a female researcher that began with an open-ended question about dyspareunia and included interview prompts related to the nature of sexual pain. Interviews were recorded, transcribed verbatim, and analysed for themes. Results 17 participants completed interviews. The mean participant age was 33.3 (SD=7.2) and most participants identified as white (82%), were college-educated (71%), identified as heterosexual (65%), and were partnered (59%). Location, onset, and character emerged as important, interrelated features of endometriosis-associated dyspareunia, as did severity and impact. Dyspareunia occurred at the vaginal opening (n=7) and in the abdomen/pelvis (n=13). Pain at the vaginal opening began with initial penetration and had pulling, burning and stinging qualities. Pain in the pelvis was typically experienced with deep penetration or in certain position and was described as sharp, stabbing and/or cramping. Dyspareunia ranged from mild to severe, and for some participants had a marked psychosocial impact. Conclusions Dyspareunia is a heterogeneous symptom of endometriosis that ranges in severity and impact. Disaggregating dyspareunia into superficial and deep types may better reflect the etiologies of this pain, thereby improving outcome measurement in intervention studies and clinical care.

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endometriosisdyspareunia

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