Genital pain and vaginal discharge are commonly reported gynecological symptoms, but frequency, duration, and association with sexual practices is unknown. The objective of this research was to describe the prevalence of genital pain, pelvic cramps, and vaginal discharge and to evaluate their relationship of symptom duration to event-level sexual behaviors.
Methods
Data were daily diaries collected from young women (N = 387), ages 14 - 17 yrs at enrollment. Symptom variables were genital pain (no/yes), vaginal discharge (no/yes) and cramps (no/yes). Symptom duration for genital pain, vaginal discharge or cramps was calculated as the number of consecutive days on which symptoms were noted as well as for the number of days on which 2 or more symptoms were observed. Event level sexual behaviors included coitus (no/yes), condom use during coitus (no/yes), fellatio (no/yes), cunnilingus (no/yes), anal sex (no/yes), touching a partner’s genitals (no/yes) and having one’s genitals touched (no/yes).
Results
Subjects reported 87,311 diary days; 2% were associated with genital pain (1,654/87,311), 6.5% were associated with vaginal discharge (5,680/87,311) and 6% were associated with cramps (5,139/87,311). Most days (87%; 76,135/87,311) had no symptoms; subjects reported one symptom on 10% of days (8,731/87,311) and 2 or more symptoms on 3% of days (2,445/87,311). On average, genital pain duration was 8.79 days (SD = 16.31), vaginal discharge duration was 7.38 days (SD = 13.37) and cramps duration was 9.48 days (SD = 13.39); duration of two or more symptoms was 11.5 days (SD = 17.03). Controlling for vaginal bleeding, mood, partner effects, substance use and usual behaviors, longer duration of genital pain increased the likelihood of cunnilingus (OR = 1.09), but decreased the likelihood of coitus (OR = 0.93), fellatio (OR = 0.93), touching a partner’s genital (OR = 0.92) and having one’s genitals touched (OR = 0.94). A longer duration of cramps was associated with decreased likelihood of coitus (OR = 0.87). Longer duration of vaginal discharge was associated with increased likelihood of fellatio (OR = 1.04), but decreased likelihood of cunnilingus (OR = 0.88), anal sex (OR = 0.63), and coitus with a condom (OR = 0.8). A longer duration of two or more symptoms decreased the likelihood of all sexual behaviors (OR = 0.86 - 0.96), but was not associated with condom use.
Conclusions
Genital pain, cramps, and vaginal discharge appear to have complex relationships with sexual behavior, even in the absence of vaginal bleeding. These findings provide useful insights into the ways young women organize their sexual behaviors, and suggest ways, in which young women may be taught to recognize, interpret and respond to genital and pelvic symptoms.
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