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We limited our sample to adult women who reported a sexual experience that was painful in the past year (n\u00a0= 382; 23.2%). The primary outcome in quantitative analyses was whether women told their partner they experienced pain during sex. Associations with social identities and sexual health were explored via logistic regression. Those who did not tell their partner about painful sex were asked why; their accounts were coded and analyzed qualitatively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measure<\/jats:title>\n                  <jats:p>Women were asked, \u201cTo what extent was this sexual experience physically painful for you?\u201d Those who reported any pain were asked, \u201cDid you tell your partner that you were in pain during sex?\u201d and, if applicable, \u201cWhy didn\u2019t you tell your partner that you were in pain during sex?\u201d<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of those reporting pain during sex, most said it was \u201ca little painful\u201d (81.6%) and occurred at the vaginal entrance (31.5%), inside the vagina (34.4%), or at or around the cervix (17.4%). Overall, 51.0% (n\u00a0= 193\/382) told their partner about their pain. Adjusting for age and wantedness, women who reported little or no event-level sexual pleasure had nearly 3-fold greater odds of not telling a partner about painful sex (adjusted odds ratio\u00a0= 3.24; 95% CI, 1.43\u20137.37). Normalizing painful sex, considering pain to be inconsequential, prioritizing the partner\u2019s enjoyment, and gendered interactional pressures were the predominant themes in women\u2019s narratives.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Implications<\/jats:title>\n                  <jats:p>Providers should ask about painful sex, if the woman continues intercourse despite pain, and how she feels about this as a means of assessing any sexual and social pressures.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths &amp; Limitations<\/jats:title>\n                  <jats:p>Strengths include the use of social theory in nationally representative survey research to examine how contextual factors influence sexual health, but experiences were largely limited to heterosexual interactions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Many women do not discuss painful sex with their partners, lack of pleasure is significantly more likely among this group, and gender norms and cultural scripts are critical to understanding why.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1016\/j.jsxm.2019.08.016","type":"journal-article","created":{"date-parts":[[2019,9,21]],"date-time":"2019-09-21T13:31:06Z","timestamp":1569072666000},"page":"1953-1965","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":52,"title":["\u201cFulfilling His Needs, Not Mine\u201d: Reasons for Not Talking About Painful Sex and Associations with Lack of Pleasure in a Nationally Representative Sample of Women in the United States"],"prefix":"10.1093","volume":"16","author":[{"given":"Allison","family":"Carter","sequence":"first","affiliation":[{"name":"Kirby Institute, University of New South Wales Sydney , Sydney , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessie V.","family":"Ford","sequence":"additional","affiliation":[{"name":"School of Sociomedical Sciences, Mailman School of Public Health, Columbia University , New York, NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Luetke","sequence":"additional","affiliation":[{"name":"Center for Sexual Health Promotion, School of Public Health-Bloomington, Indiana University , Bloomington, IN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsung-chieh (Jane)","family":"Fu","sequence":"additional","affiliation":[{"name":"Center for Sexual Health Promotion, School of Public Health-Bloomington, Indiana University , Bloomington, IN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Townes","sequence":"additional","affiliation":[{"name":"Center for Sexual Health Promotion, School of Public Health-Bloomington, Indiana University , Bloomington, IN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devon J.","family":"Hensel","sequence":"additional","affiliation":[{"name":"Division of Adolescent Medicine, Indiana University School of Medicine , Indianapolis, IN , USA"},{"name":"Department of Sociology, Indiana University-Purdue University Indianapolis , Indianapolis, IN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Dodge","sequence":"additional","affiliation":[{"name":"Center for Sexual Health Promotion, School of Public Health-Bloomington, Indiana University , Bloomington, IN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debby","family":"Herbenick","sequence":"additional","affiliation":[{"name":"Center for Sexual Health Promotion, School of Public Health-Bloomington, Indiana University , Bloomington, IN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,9,21]]},"reference":[{"key":"2023012309475884700_bib1","first-page":"151","article-title":"A\u00a0desire to be \u2018normal\u2019? 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