Temporal Relationships Between Pain During Intercourse (PDI), Loneliness, and Depressive Symptoms Among Women

Background: Painful sex can lead to increased psychological distress, including major depressive disorder, and the experience of loneliness may explain this association. Aims: We aimed to investigate loneliness as a mediator between painful sex and depressive symptoms and hypothesized that women who experienced greater pain during intercourse (ie, more severe and more frequent pain) would endorse higher rates of loneliness and, in turn, higher rates of depressive symptoms at a 6-month follow-up. Methods: Participants were 148 adults who were assigned female at birth (78.4% white, 77% partnered, 31.14 +/- 10.9 years old) and completed an online, anonymous survey including the Female Sexual Function Index (FSFI), UCLA Loneliness Scale-3 (ULS), and demographic information. Main Outcome Measure: Depressive symptoms, measured via the Patient Health Questionnaire-8 (PHQ8) at baseline (T1) and 6-month follow-up (T2) were used as the outcomes of the present study. Results: Painful sex and ULS at T1 were significantly correlated with each other and with PHQ8 at T1 (r = 0.590). However, change in PHQ8 from T1 to T2 was not significantly correlated with ULS (r = 0.024) or any other key study variables, indicating that that ULS was not a significant mediator of the relationship between painful sex at T1 and change in PHQ8 (standardized indirect effect = 0.011; 99% CI = -0.114 to 0.188). Conclusion: These findings are consistent with previous studies highlighting that painful sex is related to depressive symptoms through loneliness cross-sectionally, suggesting that future treatments for depressive symptoms among women who experience painful sex might target loneliness. Copyright (C) 2021, International Society of Sexual Medicine. Published by Elsevier Inc.