{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:34:41Z","timestamp":1788395681916,"version":"build-2803163510"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2019,5,30]],"date-time":"2019-05-30T00:00:00Z","timestamp":1559174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2019,5,30]],"date-time":"2019-05-30T00:00:00Z","timestamp":1559174400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"funder":[{"DOI":"10.13039\/501100004484","name":"Tehran University of Medical Sciences","doi-asserted-by":"crossref","award":["34044"],"award-info":[{"award-number":["34044"]}],"id":[{"id":"10.13039\/501100004484","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Tehran University of Medical Sciences","award":["34044"],"award-info":[{"award-number":["34044"]}]}],"content-domain":{"domain":["jsm.jsexmed.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>To date, few studies have investigated the prevalence of sexual pain in the context of the new diagnostic concept of genito-pelvic pain\/penetration disorder (GPPPD).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To evaluate the prevalence of GPPPD and its associated factors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a population-based, cross-sectional study of 590 healthy married women age 18\u201370 years conducted between May and October 2017 in Tehran, Iran.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measures<\/jats:title>\n                  <jats:p>Research tools included demographic characteristics checklist, factors affecting GPPPD, sexual distress and self-reporting of pain during intercourse, 2 standard questionnaires on depression (Patient Health Questionnaire 9) and Binik\u2019s guideline for the diagnosis of GPPPD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>196 women (33%) reported pain or fear in answer to self-report questions. Administration of Binik\u2019s guideline yielded a GPPPD prevalence of 16% (n\u00a0= 94 women); however, this number decreased to 62 women (10.5%) when sexual distress was taken into account; thus, the final prevalence of GPPPD was considered to be 10.5%. However, if the threshold in Binik\u2019s guideline was lowered to also include those reporting \u201csomewhat\u201d pain in addition to the group reporting \u201cmoderate\u201d and \u201cquite a bit or always,\u201d then the prevalence of GPPPD increased to 25.8%. The results of backward logistic regression identified a strong aversion to looking at or touching the genitalia (odd ratio [OR]\u00a0= 4.3), low sexual satisfaction (OR\u00a0= 3.1), and severe depression (OR\u00a0=\u00a06.6) as independent risk factors for a diagnosis of GPPPD and secure financial status (OR\u00a0= 0.3) and a high level of marital satisfaction (OR\u00a0= 0.2) as protective factors against a diagnosis of GPPPD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Implications<\/jats:title>\n                  <jats:p>Reliable diagnosis of GPPPD is crucial. Application of validated tools may mitigate the overestimation of GPPPD prevalence. Simultaneously, clinicians\u2019 judgment is essential in assessing a reasonable threshold and preventing underestimation that leads to the exclusion of women suffering from pain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths &amp; Limitations<\/jats:title>\n                  <jats:p>The present study is one of the few evaluating the prevalence of GPPPD according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) definition and Binik\u2019s guideline. The study also aims to point out some new perspectives on merging the 2 concepts of vaginismus and dyspareunia. Study limitations include the evaluation of factors affecting GPPPD based on self-reporting and possible recall bias.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Further research is needed to determine the appropriate threshold for a diagnosis of GPPPD. We suggest that a woman with mild to moderate pain or fear of vaginal penetration is under sexual distress and cannot be neglected. In addition, problems may arise following the DSM-5 merging of the 2 disorders of vaginismus and dyspareunia, owing to the significant prevalence and distress of lifelong vaginismus in some cultures.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1016\/j.jsxm.2019.04.019","type":"journal-article","created":{"date-parts":[[2019,5,31]],"date-time":"2019-05-31T02:54:43Z","timestamp":1559271283000},"page":"1068-1077","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":36,"title":["Prevalence of and Risk Factors for Genito-Pelvic Pain\/Penetration Disorder: A Population-Based Study of Iranian Women"],"prefix":"10.1093","volume":"16","author":[{"given":"Ameneh","family":"Alizadeh","sequence":"first","affiliation":[{"name":"Department of Reproductive Health , Tehran, \u00a0 Iran"},{"name":"School of Nursing and Midwifery , Tehran, \u00a0 Iran"},{"name":"Tehran University of Medical Sciences , Tehran, \u00a0 Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farnaz","family":"Farnam","sequence":"additional","affiliation":[{"name":"Department of Reproductive Health , Tehran, \u00a0 Iran"},{"name":"School of Nursing and Midwifery , Tehran, \u00a0 Iran"},{"name":"Tehran University of Medical Sciences , Tehran, \u00a0 Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Firoozeh","family":"Raisi","sequence":"additional","affiliation":[{"name":"Department of Psychiatry , Tehran, \u00a0 Iran"},{"name":"Roozbeh Hospital , Tehran, \u00a0 Iran"},{"name":"Tehran University of Medical Sciences , Tehran, \u00a0 Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahboubeh","family":"Parsaeian","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics , Tehran, \u00a0 Iran"},{"name":"School of Public Health , Tehran, \u00a0 Iran"},{"name":"Tehran University of Medical Sciences , Tehran, \u00a0 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