Pelvic pain is a common but often overlooked sexual health concern—affecting people’s bodies, intimate relationships, emotional well-being, and quality of life.
Despite its broad impact, the research that shapes clinical knowledge and treatment guidelines has historically focused on a narrow demographic: White, same-sex, heterosexual women. As a result, entire communities experiencing sexual pain have been excluded from the evidence base that guides diagnosis, care and policy.
A new global review of the scope, which examines 227 studies on genital pelvic painbrings this issue into focus. By assessing what is known—and, more importantly, what remains unknown—about genital pelvic pain in minority populations, the review highlights the urgent need for more comprehensive research.
This work represents one of the most comprehensive efforts to date to map the landscape of genital pain in various communities—and highlights how much remains to be done.
What is Pelvic Pain?
Pelvic pain refers to persistent or recurring pain in the genital or pelvic area that may occur before, during, or after sexual activity, penetration, or even when inserting a tampon. These experiences vary widely, but commonly discussed conditions include:
Blowing: involuntary stretching or contraction of the vaginal musclesoften making penetration painful or impossible.
Dyspareunia: pain in the genitals during or after penetration. Pain can occur in the pelvic floor muscles, within the vaginal canal, in the tissue of the vulva, or as a deeper pain in the abdomen or uterus. It is important that dyspareunia is it is not limited to people with sinuses— people with a penis may experience genital and pelvic pain, including pain in the testicles, pelvic floor tension, or pain along the shaft of the penis.
Vulvodynia: chronic pain or discomfort of the vulva without an identifiable cause, often described as burning, stinging, irritation, or discharge.
Other pelvic floor related pain syndromes: including pelvic myalgia, post-surgical pelvic pain, endometriosis-related pain and other conditions affecting sexual function.
At DSM-5vagus and dyspareunia are combined in the diagnosis of Genipelvic Pain/Penetrating Disorder (GPPPD), although many people experience symptoms that overlap or do not fit into strict diagnostic categories.
Regardless of the label, Genital pain can affect sexual desire, arousal, lubrication, relationship satisfaction and emotional well-being.
For many individuals, shame, stigma, and lack of access to culturally responsive care exacerbate both the physical and psychological experience of pain—an issue that disproportionately affects people in marginalized communities.
What the review found: Gaps, obstacles and missed opportunities
1. A limited—and uneven—evidence base
Worldwide estimates of genital pain range from 8% to 22%although some studies report much higher rates. In the new scope overview, Estimates ranged widely—from 2% to 90% overall and from 3% to 62% among gender and sexual minority groups.
Despite its prevalence, very few studies have focused on racial or ethnic minority populations, LGBTQ+ individuals, adolescents, or individuals of lower socioeconomic status. And when these groups were included, the research was inconsistent—using different definitions, measures, and sample types—making it difficult to compare results or identify clear patterns.
An American study showed why representation matters: WSuccessful women tended to use “traditional descriptors” for pain, while Black and Asian women often chose “none of these descriptors,” suggesting that existing tools may not capture everyone’s experiences.
A narrow evidence base influences treatment guidelines, provider communication, funding, and policy. When entire groups are left out of research, their health outcomes are at risk.
2. Structural barriers are too often ignored
A major limitation identified in the review is that structural and underlying factors – those that shape how sexual pain is experienced, reported and treated – are rarely measured or recognised.
These factors may include:
Racism and discrimination
Historical and contemporary medical mistrust
Migration stress and acculturation pressures
Language barriers and lack of culturally competent clinicians
Financial and insurance barriers
Gender expectations and cultural norms
Exposure to trauma, including sexual or obstetric trauma
Without understanding how these contexts influence patients’ experiences and decision-making, interventions will remain incomplete. Pelvic pain cannot be effectively treated without recognizing the environment in which people live, love and seek care.
3. Sexual orientation and gender identity are implied
Another important finding from the review is that very few studies focused on LGBTQ+ participants. This is an important gap because existing research shows mixed results when comparing pain levels between sexual and gender groups. Several important factors have been linked to genital pelvic pain, including:
Without meaningful inclusion of LGBTQ+ people, clinicians lack the information they need to provide supportive, affirming, community-centered care. This lack of research also reinforces the harmful stereotype that genital pain only affects heterosexual women, when in fact it can affect people of all genders and sexualities.
4. Cultural narratives shape experiences of pain—but research rarely captures them
Cultural beliefs and socialization shape how individuals understand sexual pain, whether they seek help, and how they communicate their needs to partners and providers. However, only a small proportion of the studies reviewed investigated cultural or relational contexts such as:
Gender norms and expectations
Taboos around discussing sexuality or pain
Ideas about virginity, penetration or sexual obligation
Stigma around pelvic exams
Family or social pressures
Religious or cultural teachings related to sexuality
These narratives profoundly influence pain experiences, but remain underexplored in clinical research.
Why it matters to sexual health professionals
Understanding pelvic pain in minority groups isn’t just a research priority—it’s imperative.
When pain goes unrecognized or untreated, the consequences include:
Loss of sexual pleasure
Decreased desire
Avoiding sexual intimacy
Conflict or disconnection in relationships
Increased anxiety, depression or anxiety
Feelings of shame or guilt
Reduced trust in health systems
For sexual health professionals, the review highlights the need to:
Inclusive research practices that accurately represent diverse populations
Culturally responsive and trauma-informed care
Intersectional approaches that recognize overlapping experiences of marginalization
Advocacy and education that normalize conversations about sexual pain
Community-driven interventions tailored to people’s lived experiences
Recognizing the diversity in sexual pain experiences allows providers to offer more accurate diagnoses, more effective treatment plans, and more compassionate care.
Moving Forward: Where We Go From Here
As the field evolves, researchers and clinicians have an opportunity—and a responsibility—to build more equitable frameworks for understanding and treating fertility pain.
The review notes that methodology is already being improved, particularly through the development of more comprehensive and culturally sensitive questionnaires. However, much more work remains. A fairer future requires:
Recruitment strategies that reach underrepresented communities
Research bodies representing cultural and linguistic diversity
Attention to the social determinants of health
Collaboration with community organizations and patient advocates
Training for clinicians about biases and structural inequalities
Funding priorities that address gaps rather than reinforce the status quo
For sexual health professionals, this review is an important reminder that genital pain looks different for everyone. A person’s experience can be shaped by who they are, their background, their culture, their relationships and the type of care they can access.
Interested in learning more? Join the SHA Community
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Together, we can create a space where everyone’s sexual health stories—and experiences of pain—are heard, validated, and supported.
