History of Sexual and Physical Abuse in Women with Dyspareunia: Association with Pain, Psychosocial Adjustment, and Sexual Functioning

Abstract

Aim Dyspareunia is a women’s sexual health problem that still often goes undiagnosed despite its high prevalence and its detrimental impact on sexual, relationship, and psychological adjustment. Although sexual and physical abuse may constitute risk factors for the development of dyspareunia, the effects of past abuse on current pain and associated sexual and psychosocial impairments have never been examined. Thus, the aim of this study is to determine the relation between a history of sexual and physical abuse and a series of pain, psychological, dyadic, and sexual functioning variables in a sample of women with dyspareunia. Methods A hundred and fifty-one women took part in the study via health professional referrals and advertisements in local newspapers. Each participant underwent a standardized gynecological examination and a structured interview in order to confirm the diagnosis of dyspareunia. They also completed self-report questionnaires investigating past sexual and physical abuse, in addition to current pain, psychosocial adjustment, and sexual functioning. Dependent measures included: (i) The Brief Symptom Inventory; (ii) the Sexual History Form; and (iii) the Locke-Wallace Marital Adjustment Scale. Pain was assessed via the McGill Pain Questionnaire and a visual analogue scale. Results Results revealed that a history of sexual abuse involving penetration was associated with poorer psychological adjustment and sexual functioning. Additionally, findings showed that women who perceived a link between their dyspareunia and their past sexual abuse reported worse sexual functioning than those who did not. Finally, the experience of sexual abuse was not associated with pain intensity and physical abuse was not associated with any of the outcome measures. Conclusions Findings suggest that the presence of a sexual abuse history in women with dyspareunia is associated with increased psychological distress and sexual impairment, although there is no relation between a history of physical abuse and these outcomes.

Childhood sexual abuse moderates the association between sexual functioning and sexual distress in women

“…An important factor that has been repeatedly linked to both sexual functioning and sexual distress, and which may serve a similar moderating role, is a history of childhood sexual abuse (CSA), defined here as unwanted sexual contact before the age of 16. Many studies have found that women with a history of CSA report poorer sexual functioning than women without a history of sexual abuse (NSA) across the lifespan (Dennerstein, Guthrie, & Alford, 2004), and have a higher prevalence of sexual dysfunction (Kinzl, Traweger, & Biebl, 1995; Leclerc, Bergeron, Binik, & Khalife, 2010; Loeb et al, 2003; Najman, Dunne, Purdie, Boyle, & Coxeter, 2005; Sarwer & Durlak, 1996). Women with CSA histories also report lower levels of sexual satisfaction relative to NSA women (Browne & Finkelhor, 1986; Jackson, Calhoun, Amick, Maddever, & Habif, 1990), as well as greater levels of sexual distress (Merrill et al, 2003; Rellini & Meston, 2007).…”

Management of Female Sexual Pain Disorders

“…Controlled research has supported an association between these factors in women with chronic pelvic pain [67] and vaginismus [52]; however, findings have been inconsistent in women with vulvodynia [68][69][70]. A recent study found that psychological and sexual function were lower in women with dyspareunia who had experienced penetrative sexual abuse [71]. Therefore, although sexual abuse may not be more common in women with sexual pain disorders than in the general population, experiencing such abuse may be related to more severe psychological and sexual sequelae.…”

Traumatic childhood sexual events and secondary sexual health complaints in neurotic disorders

“…Is the use of self-administered questionnaires really helpful in the evaluation at pretreatment of neurotic patients with accompanying sexual dysfunction? Other investigators, particularly in Polish studies [40], have reported predominantly on data from questionnaires devoted to certain sexual dysfunctions [20][21] and to specific subpopulations [17][18]36].…”

“…They affect orgasm and/or sexual drive, disturb relationships [18], and predict vestibulodynia [19], dyspareunia [20], and vulvodynia [21]. For instance, the latter is estimated 4.4 times more likely to be reported if the perpetrator was a primary family member, and 6.5 times if the abuse was frequent.…”