INTRODUCTION: Dyspareunia remains under-investigated despite recent population-based studies indicating that its prevalence ranges from 12% to 21% in adult women. Although clinical data suggest that dyspareunia can begin during adolescence, a large-scale epidemiological study has yet to be conducted with this population. AIMS: To determine the prevalence and characteristics of dyspareunia in a large-scale sample of adolescents, in addition to the characteristics of vulvo-vaginal insertion pain in nonsexual contexts. METHODS: With written informed consent, data were obtained from 1,425 girls (12-19-year-olds), from seven metropolitan high schools during regular school hours using a self-report questionnaire. MAIN OUTCOME MEASURES: Dyspareunia prevalence was evaluated by asking sexually active participants whether or not they regularly (at least 75% of the time) experienced pain during intercourse. Pain duration, context of onset, location, intensity, and pain during tampon insertion and pelvic exams were evaluated. RESULTS: Results revealed that 20% of sexually active girls (N = 251) reported having regular pain during intercourse for at least 6 months or more. A primary form of pain was reported by 67% of adolescents and significantly more girls with chronic dyspareunia identified the vaginal opening (39%; x=3.9/10) as being their most painful site compared with internal pain sites (18-29%; x=2.9-3.2/10) (P = 0.042). Chronic dyspareunia cases reported significantly more pain during first and usual tampon insertion (P = 0.003; P = 0.009) than pain-free controls, while no difference was found between groups regarding pelvic exams (P = 0.086). Experiencing severe pain at first tampon insertion was linked to a fourfold risk of reporting chronic dyspareunia (P = 0.001). CONCLUSIONS: Results mirror prevalence estimates found in population-based studies with adult women and suggest that chronic dyspareunia is a significant sexual health problem in adolescent girls, with pain extending beyond intercourse to nonsexual contexts.
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机译：引言：尽管最近的人群研究表明，成年女性的性交困难症患病率仍在12％到21％之间，但仍进行了调查不足。尽管临床数据表明，性交困难可以在青春期开始，但尚未对该人群进行大规模的流行病学研究。目的：除了在非性情境中外阴-阴道插入疼痛的特征外，还要确定大规模青少年样本中的性交困难的患病率和特征。方法：在知情同意书的基础上，使用自我报告调查表从定期上课时间从七所城市中学的1,425名女孩（12-19岁）获得数据。主要观察指标：通过询问性活跃参与者的性交时是否定期（至少75％的时间）经历疼痛来评估性交困难的患病率。评估疼痛持续时间，发作情境，位置，强度和在棉塞插入和盆腔检查期间的疼痛。结果：结果显示，有20％的性活跃女孩（N = 251）报告在性交中持续疼痛至少6个月或更长时间。 67％的青少年报告了主要的疼痛形式，与内部疼痛部位（18-29％; 18-29％; 50％的慢性疼痛）相比，发现阴道开口（39％; x = 3.9 / 10）是她们最痛苦的部位。 x ＝ 2.9-3.2 / 10）（P ＝ 0.042）。与没有疼痛的对照组相比，慢性痛经病例在首次和常规棉塞插入过程中的疼痛明显增加（P = 0.003; P = 0.009），而两组骨盆检查之间无差异（P = 0.086）。首次插入棉塞时出现严重疼痛与报告慢性痛经的四倍风险相关（P = 0.001）。结论：结果反映了在成年女性人群研究中发现的患病率估计值，并表明慢性痛经是青春期女孩的重要性健康问题，其痛苦范围从性交延伸到非性生活。
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