The Relationship of Age of First Sexual Activity to Pain and Psychological Symptoms Among Women with Urogenital Pain.

Objective: Age of first sexual activity (AFSA) may be a developmental marker linked to later clinical status (e.g., pain, depression). However, correlates of AFSA have not been examined in chronic pain populations and are unknown in women with urogenital pain.

Methods: A series of 309 women (age M = 48.4 years) presenting to a tertiary women's urology center with urogenital pain completed a comprehensive intake survey, which included their AFSA and measures of pain severity and interference, depression, anxiety, adverse childhood experiences, and childhood abuse.

Results: The mean AFSA was 18 years (median = 17). AFSA was significantly, inversely related to pain intensity (r = -0.16), pain interference (r = -0.20), and depression (r = -0.11). Curvilinear (quadratic) associations were also identified; scatter plots and age-group comparisons showed that these inverse relationships flattened or slightly reversed for AFSA after the college years. Analyses also found that childhood adversities and childhood abuse predicted an earlier AFSA.

Conclusions: Among women with urogenital pain, an earlier AFSA is associated with worse pain and distress, at least through the college years. Earlier sexual activity may directly increase risk for later pain and distress or serve as a marker of other risk factors-such as childhood adversity or abuse. A relatively late AFSA is not protective in this sample, perhaps due to psychological or interpersonal factors associated with a later first sexual experience. Clinical inquiry into AFSA may provide insight into risk factors for urogenital pain and distress.