性交痛是女性的一种常见症状。
流行病学
性交痛的患病率差异很大，具体取决于抽样人群和定义。系统评价报告的性交痛患病率为 8%-35%。[1]Latthe P, Latthe M, Say L, et al. WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity. BMC Public Health. 2006 Jul 6;6:177.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1550236
http://www.ncbi.nlm.nih.gov/pubmed/16824213?tool=bestpractice.com
[2]Banaei M, Kariman N, Ozgoli G, et al. Prevalence of postpartum dyspareunia: A systematic review and meta-analysis. Int J Gynaecol Obstet. 2021 Apr;153(1):14-24.
http://www.ncbi.nlm.nih.gov/pubmed/33300122?tool=bestpractice.com
英国一项调查发现，7.5% 有性行为的女性自诉存在性交痛。[3]Mitchell KR, Geary R, Graham CA, et al. Painful sex (dyspareunia) in women: prevalence and associated factors in a British population probability survey. BJOG. 2017 Oct;124(11):1689-97.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5638059
http://www.ncbi.nlm.nih.gov/pubmed/28120373?tool=bestpractice.com
在美国，估计 10%-20% 的女性存在性交痛。[4]Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA. 1999 Feb 10;281(6):537-44.
https://jamanetwork.com/journals/jama/fullarticle/188762
http://www.ncbi.nlm.nih.gov/pubmed/10022110?tool=bestpractice.com
[5]Fuldeore MJ, Soliman AM. Prevalence and symptomatic burden of diagnosed endometriosis in the United States: national estimates from a cross-sectional survey of 59,411 women. Gynecol Obstet Invest. 2017;82(5):453-61.
http://www.ncbi.nlm.nih.gov/pubmed/27820938?tool=bestpractice.com
分类
性交痛和阴道痉挛在 DSM-5-TR 中被归类为生殖器-盆腔疼痛/插入障碍。[6]American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022. 这类疾病分为：持续性或复发性阴道插入困难，在插入期间或在试图插入时出现明显的盆腔或外阴阴道疼痛，在插入前、插入时或插入后对疼痛感到恐惧或焦虑，以及在试图插入时盆底肌收紧或绷紧。[7]IsHak WW, Tobia G. DSM-5 changes in diagnostic criteria of sexual dysfunctions. Reprod Sys Sexual Disorders 2013;2:122. DSM-5-TR 标准规定，症状必须已存在约 6 个月，导致患者出现具有临床意义的痛苦，且不能通过非性精神障碍、关系痛苦的结果或其他显著应激源来更好地解释。[6]American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.
性交痛可分为原发性性交痛和继发性性交痛；浅部性交痛和深部性交痛。[8]MacNeill C. Dyspareunia. Obstet Gynecol Clin N Am. 2006;33:565-577.
http://www.ncbi.nlm.nih.gov/pubmed/17116501?tool=bestpractice.com
