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Why do young women continue to have sexual intercourse despite pain?
Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine . Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0003-1588-135X
2008 (English)In: Journal of Adolescent Health, ISSN 1054-139X, Vol. 43, no 4, 357-363 p.Article in journal (Refereed) Published
Abstract [en]

Purpose: Many young women suffer from pain and discomfort during sexual intercourse, and an increasing number of them seek help for their problems. It seems that some young women continue to have sexual intercourse despite pain. However, their motives are unclear.

Methods: A total of 16 women, aged 14-20 years, with variable degrees of coital pain were selected at a youth center in a city in southeastern Sweden, to explore why they continued to have sexual intercourse despite pain. The women participated in audiotaped qualitative individual interviews, which were analyzed using the constant comparative method from grounded theory.

Results: During the analysis we identified the core category striving to be affirmed in their image of an ideal woman and the categories resignation, sacrifice and feeling guilt.

The perceived ideal women had several distinct characteristics, such as willingness to have sexual intercourse, being perceptive of their partner’s sexual needs, and being able to satisfy their partners.

Having sexual intercourse per se was considered to be an affirmation of being a normal woman, irrespective of pain or discomfort.

Conclusions: These young women’s focus on a constructed ideal explains why they continue to have sexual intercourse despite pain.

Greater awareness of these beliefs among gynaecologists, sexologists, and other healthcare professionals involved in the management of young women with coital pain would be beneficial.

Place, publisher, year, edition, pages
New York: Elsevier Inc. , 2008. Vol. 43, no 4, 357-363 p.
Keyword [en]
Adolescent; Coital pain; Constant comparative analysis/method; Dyspareunia; Sexual intercourse
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:liu:diva-21144DOI: 10.1016/j.jadohealth.2008.02.011OAI: oai:DiVA.org:liu-21144DiVA: diva2:240830
Available from: 2009-09-30 Created: 2009-09-29 Last updated: 2013-09-12Bibliographically approved
In thesis
1. Painful Ideals: Young Swedish women´s ideal sexual situations and experiences of pain during vaginal intercourse
Open this publication in new window or tab >>Painful Ideals: Young Swedish women´s ideal sexual situations and experiences of pain during vaginal intercourse
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Smärtsamma Ideal : Unga svenska kvinnors ideala sexuella situationer och erfarenheter av smärta vid samlag
Abstract [en]

Many young women today are concerned about their sexual health; an increasing number of them consult gynaecologists, youth centres (YCs) and general practitioners with vulvar problems such as painful sensations associated with vaginal intercourse (VIC). It is known that some women continue to have VIC despite pain. Theoretically, repeated painful VIC might elicit vaginistic reactions, which may increase the pain and induce vicious circles. Since many clinicians and researchers nowadays notice that pain during VIC often starts at young age, it is important to investigate how pain during VIC starts and is maintained in younger populations. The overall aim of this thesis was to investigate young women’s experiences of ideal sexual situations and pain during VIC.

Women aged 13-22 years participated in our studies, which used both quantitative (study I and IV) and qualitative (study II and III) methods. For paper I, a questionnaire was developed and used in a YC sample (n=300); informants for paper II were selected from that sample to participate in qualitative interviews (n=16). Another qualitative interview study for paper III with a complimentary research question was conducted in a different YC sample (n=14). For paper IV, a questionnaire was developed based on the results from study I, II and III to test the hypotheses derived from study II in a sample of female high school students (n=1566).

The findings revealed that 65% of the women reported pain related to first VIC. Among those who reported VIC during the previous month, 49% had experienced pain and/or discomfort during VIC during that same period (paper I). In paper IV, 47% of the women reported experience of pain and/or discomfort during VIC, and among those, 47% continued to have VIC, 22% feigned enjoyment, and 33% omitted telling the partner about their pain. In paper II, the women’s reasons for continuing to have VIC despite pain were: striving to reach their ideal image of a woman, characterized as always willing to have VIC; being perceptive of their partner’s sexual needs; and being able to satisfy their partner. In paper IV the hypotheses derived from study II were confirmed and showed, for example that a significantly higher proportion of women who continue to have VIC despite pain than women who did not had difficulty refusing sex when the partner wants it, felt inferior to the partner during sex, regarded the partner’s satisfaction as more important than their own, felt dissatisfaction with their sex life, and feigned enjoyment despite pain. In a multivariate model, continuing to have VIC despite pain was associated with feelings of being inferior to the partner during sex (adjusted OR 1.82; CI 1.10-3.02), dissatisfaction with their own sex lives (adjusted OR 1.76; CI 1.14-2.72) and feigning enjoyment while having pain (adjusted OR 7.45; CI 4.37-12.69).

The major reason for continuing to have VIC was that the partner’s enjoyment was prioritized higher than their own (paper IV). In paper III, we found that women without pain during VIC also felt pressure from social norms and demands and had experienced partners “driving their own race”. However, they managed to some extent to resist these unequal gender norms because of their urge to experience pleasure.

In conclusion, pain during VIC is a common complaint among young Swedish women, and a high proportion of them continue having VIC despite pain. The women’s notion of prioritizing the partners´ enjoyment before their own illustrates that unequal gender regimes affect young women’s (hetero)sexuality negatively.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2009. 74 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1145
Keyword
Adolescent, Coital pain, Constant comparative analysis/method, Dyspareunia, Gender, Sexual intercourse, Sexual situation, Vaginal intercourse, Young women
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-20277 (URN)978-91-7393-561-6 (ISBN)
Public defence
2009-09-25, Berzeliussalen, Campus US, Linköpings Universitet, Linköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2009-10-06 Created: 2009-09-01 Last updated: 2012-02-03Bibliographically approved

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Elmerstig, EvaWijma, BarbroBerterö, Carina

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Gender and medicine Faculty of Health SciencesDepartment of Gynecology and Obstetrics in LinköpingNursing Science
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