Age of sexual debut and central introital dyspareunia

Analysis of characteristics of patients with introital central dyspareunia. Is late coitarche (age at first sexual intercourse) a risk factor for introital dyspareunia?

145 women attending a vulvo-vaginitis clinic in secondary and tertiary care center in Tienen and Leuven, Belgium, with central introital pain during sexual intercourse.

The mean age of the study group was 32 years, and 5% were 60 years of age or older. Of the patients, 51% had primary and 49% secondary dyspareunia. Before referral, two-thirds of the patients had already tried several types of therapy, including psychiatric help in 16% of cases. The study group of patients with central introital dyspareunia had a coitarche at a mean of 18.3 years. 72% of the dyspareunic women with coitarche later than 18 had to regularly interrupt intercourse because of pain, compared with 52% of women with coitarche before 18 (p<0.05). A strong correlation was found between the age of sexual debut and the necessity to interrupt intercourse attempts due to pain (p<0.001). Frequency of intercourse was also found to be inversely related to coitarche.

Women with introital dyspareunia had their sexual debut at a later age than otherwise comparable women. Late coitarche is inversely related to frequency of attempted intercourse and to the necessity to interrupt intercourse due to pain, suggesting a relation between coitarchal age and severity of dyspareunia. A possible explanation is increased fibrosis and stiffening of the hymenal remnants at the posterior vulvar commissural due to increasing age in primary, and repeated injury by sexual contacts in secondary, central introital dyspareunia patients.