Racialized differences across experiences and measurements of pain in genitopelvic pain/penetration disorder

Abstract

Background: Despite a growing body of research on genitopelvic pain/penetration disorder (GPPPD), few studies have examined racial and ethnic differences. Aim: The goal of this study was to examine differences across racial groups pertaining to GPPPD with sexual vaginal intercourse in young college women at 2 public US universities. Methods: Data were collected from 1197 students from 2 public US universities. We limited our sample to 667 sexually active participants aged ≥18 years (mean, 19.21). Participants responded to survey items on their sexual history, wellness, and practices and to the Female Sexual Function Index. Data were analyzed through standard bivariate and regression analyses. Outcomes: Participants were asked, “In general, do you feel pain with sexual intercourse?” and categorized into 1 of 3 pain groups: occasional (10%-25% of the time), frequent (≥50%), and no pain (<10%). Results: GPPPD was prevalent among young college women, with 162 (24.3%) reporting pain occasionally, 119 (17.8%) frequently, and 386 (57.9%) never or very seldom. While there were no differences in pain between Latina and non-Latina participants, our analysis indicated that pain was significantly higher among all other minoritized racial groups as compared with White women but particularly high in Black women, who had 2.15-higher odds of reporting pain than White women. Differences persisted when adjusting for socioeconomic status. Specific descriptors for pain sensation were more aligned with traditional descriptors of GPPPD (eg, burning, stinging, cramping, and pinching) in the White sample than among participants of color. Pain intensity did not differ among racial groups. We also found that a significant number of participants, particularly Black women, reported experiencing painful sex occasionally. No differences were noted across racial groups when assessing sexual function with the Female Sexual Function Index. Clinical Implications: Existing surveys and physician intake forms should be critically examined for usability with patients of color. As evidenced, Black women’s GPPPD seems to go underdetected/undetected by current measures. Strengths and Limitations: This study is the first to explicitly compare racial differences among adolescents/young adults. The most notable limitation is the reliance on participant self-report and the absence of gynecologic examination to determine pain-contributing etiologies. Conclusion: Painful intercourse affects young Black women at a higher rate than White women. Further research is needed into categories and metrics that capture their experiences of pain.