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Taboos inhibit post-menopausal sex study

Published: 15 December 2006

Professor Irv Binik rarely has trouble rounding up a sample for his unfailingly fascinating research on human sexuality. But when Prof. Binik and his team solicited subjects for a study about vaginal pain in post-menopausal women, they only got 40 respondents in one year – less than half the usual response.

"It's just not an age group where people feel they have a right to be proactive in getting help for sexual problems," said the Â鶹AV psychology professor, who is also founder and director of the Sex and Couple Therapy Service of Royal Victoria Hospital, which is part of the Â鶹AV Health Centre (MUHC).

In his new study, Prof. Binik approaches the problem in two radical ways: by considering this kind of pain, called dyspareunia, a pain disorder instead of a sexual dysfunction; and by not assuming it's caused by menopause. "Traditionally, a gynecologist will blame declining estrogen levels and hand out a prescription for hormones, but that's not the only cause," he said. "The more women we interview, the better we can classify the disorder's many causes – and the more doctors will be able to prescribe the correct treatment instead of one treatment that works for some but not most."

Prof. Binik and his team need to study at least 200 women ages 45-65 to reach conclusive findings that could help the estimated 15 percent of post-menopausal women suffering from dyspareunia. For some, the pain is constant and not triggered by intercourse – some women feel genital pain in non-sexual settings, such as sports, or without any obvious cause.

But convincing women in the largely over-60 demographic to talk about sex can be extremely difficult. Taboos from the 1950s, when many of them came of age, remain an inhibiting factor. "Some of the women cry, they're so relieved to finally be talking about this," said Alina Kao, Prof. Binik's PhD student. "For many, this is the first time that they're finally discussing this lifelong problem."

In 1994, Prof. Binik's team had no problem finding enough participants for a comprehensive study on pre-menopausal dyspareunia, which resulted in the first true understanding of the disorder in younger women. Their groundbreaking work reclassified dyspareunia from a catchall description for what was mistakenly thought to be a general category of pain to different kinds of pain with several options for relief.

Starting in January, the study will be conducted at a second site – out of CHU Sainte-Justine's Gynecology Department – as well as Prof. Binik's lab on the Â鶹AV campus. To participate, please call 514-398-5323.

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