Chronic Pelvic Pain in Sexual Minority Women

Sexual minority women (i.e., lesbian, bisexual, or mostly heterosexual women) often face sexual and reproductive health disparities that may worsen their sexual health outcomes. These women tend to encounter more barriers to healthcare access and may have to contend with discrimination or negative healthcare experiences when they are able to access care. Such experiences contribute to minority stress, a situation in which the negative interactions and disproportionate difficulties that members of minority groups often experience impact their mental and physical health.

Though there is limited research on the topic, some experts speculate that sexual minority women may be disproportionately impacted by chronic pelvic pain. Chronic pelvic pain is pain in the pelvis or genitals that affects a person for at least six months and is unrelated to pregnancy, childbirth, menstrual cramps, surgery, injury, food poisoning, or the stomach flu. This condition is linked to sexual health because it can make sex less comfortable or even painful. If sexual minority women are unable to receive an accurate chronic pelvic pain diagnosis and the necessary treatment from their health care providers, they may suffer to a greater extent than heterosexual women with the same condition.

A recent study explored the prevalence of chronic pelvic pain by sexual orientation in a sample of 6,150 U.S. women between the ages of 19-27. The questionnaire, which was part of the Growing Up Today Study (GUTS), asked the young women to self-identify as “completely heterosexual,” “mostly heterosexual,” “bisexual,” “mostly homosexual,” “completely homosexual,” or “unsure.”

Additionally, the women were asked to select the genders of their past sexual partners with the options of “male,” “female,” and “both male and female.” Lastly, the participants indicated whether they had experienced chronic pelvic pain in their lifetimes, and if so, whether they received an official diagnosis from a provider and whether they had had pain in the past year.

In the end, just under half of the women (44.3%) reported experiencing chronic pelvic pain at some point in their lifetimes. Of these women, approximately 90% had had chronic pain in the past year. The trend of about half of the women experiencing chronic pelvic pain continued within each sexual orientation group: 54.3% of the bisexual women experienced chronic pelvic pain in their lifetimes, followed by 54.1% of the completely heterosexual women, and 51.8% of the lesbian women.

When the researchers examined chronic pelvic pain by gender of past sexual partners, 55.4% of the women with both male and female sexual partners had experienced lifetime chronic pain, as well as 44.1% of the women with only male partners, 36.4% of the women with only female partners, and 33.5% of the women with no past partners.

While the proportions of women in each group with chronic pelvic pain were similar, sexual minority women still had a greater risk of experiencing chronic pelvic pain. Compared to completely heterosexual women, mostly heterosexual, bisexual, and lesbian women were more likely to report having chronic pelvic pain in their lifetimes. These findings point to the need for adequate pelvic pain screening and treatment for all women, but especially for those who are sexual minority women.

Resources:

Tabaac, A.R., Chwa, C., Sutter, M.E., Missmer, S.A., Boskey, E.R., Austin, S.B., Grimstad, F., & Charlton, B. M. (2022). Prevalence of Chronic Pelvic Pain by Sexual Orientation in a Large Cohort of Young Women in the United States. The Journal of Sexual Medicine, 19(6), 1012-1023. DOI: https://doi.org/10.1016/j.jsxm.2022.03.606