Cumulative pain, rather than pain intensity, may account for associations between pain and concerns regarding sexual health in men and women, according to findings published in Pain.

For this study, the investigators collected patient data from the English Longitudinal Study of Ageing, which included 3916 participants (53.1% men) ≥50 years who reported being sexually active in the year before study entry. Participants rated pain intensities as mild, moderate, or severe. Researchers evaluated patients by sex and adjusted for age, health and lifestyle, depressive symptoms, and socioeconomic status.

At the final wave of data collection, 28.5% of women and 22.6% of men had reported experiencing moderate or severe pain within the last year. Compared with men without pain, male participants who had reported experiencing pain “were less likely to engage in frequent masturbation” (odds ratio [OR], 0.75; 95% CI, 0.57-0.99) and intercourse (OR, 0.55; 95% CI, 0.35-0.86), and expressed greater concerns regarding their sex life (OR, 2.07; 95% CI, 1.54-2.78).

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No significant associations were found between pain severity and sexual health among female participants after age adjustment. Pain and sexual health concerns were found in both men and women who had a cumulative pain score vs no pain (n=1872).

Because investigators used community-dwelling and mostly Caucasian older adults as participants in this study, it may be difficult to generalize these findings to other patient groups. In addition, the self-reported pain measures were potentially subject to recall errors, further limiting these findings.

Overall, the effects for sexual concerns appear to be more pronounced for “cumulative pain score rather than pain severity, reflecting perhaps the impact of more persistent/recurrent pain on the psychological aspects of sexual health.”

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Wade K, Wu FCW, O’Neill TW, Lee DM. Association between pain and sexual health in older people: results from the English Longitudinal Study of Ageing [published online November 25, 2017]. Pain. doi: 10.1097/j.pain.0000000000001113