Dyspareunia medical therapy: Difference between revisions

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==Medical Therapy==
==Medical Therapy==
The medical treatment of dyspareunia depends upon the cause.<ref>https://doi.org/10.18192/uojm.v7i2.2198</ref>  
The medical treatment of dyspareunia depends upon the cause.<ref>https://doi.org/10.18192/uojm.v7i2.2198</ref>  
* If vaginal dryness is the problem, prescribing very large amounts of water-soluble sexual or [[surgical lubricant]] during intercourse or increased clitoral stimulation before intercourse to ease penetration. Discourage petroleum jelly. Moisturizing skin lotion may be recommended as an alternative lubricant, unless the patient is using a [[condom]] or other latex product. Lubricant should be liberally applied (2 tablespoons full) to both the [[phallus]] and the orifice. A folded bath towel under the receiving partner's hips helps prevent spillage on bedclothes.
* If [[vaginal dryness]] is the problem, prescribing very large amounts of water-soluble sexual or [[surgical lubricant]] during [[intercourse]] or increased clitoral stimulation before [[intercourse]] to ease [[penetration]]. [[Lubricant]] should be liberally applied (2 tablespoons full) to both the [[phallus]] and the orifice.  
*Antifungal medication for vaginal yeast infections. Antibiotics will be prescribed for urinary tract infections or sexually transmitted diseases. To relieve painful inflammation, try sitz baths, which are warm-water baths in a sitting position.
*[[Antifungal]] medication for [[vaginal yeast infections]]. [[Antibiotics]] will be prescribed for [[urinary tract infections]] or [[sexually transmitted diseases]].  
*Estrogen therapy for atrophic vaginitis will be prescribed, either as a vaginal formulation or as a pill.
*[[Estrogen]] therapy for [[atrophic vaginitis]] will be prescribed, either as a [[vaginal]] formulation or as a pill.
*The treatment will vary depending on skin diseases affecting the vaginal area, . For example, lichen sclerosis and lichen planus often improve with steroid creams.
*The treatment will vary depending on skin diseases affecting the [[vaginal]] area, . For example, [[Lichen sclerosus|lichen sclerosis]] and [[lichen planus]] often improve with steroid creams.
*Typical therapies include topical estrogen cream, low-dose pain medications, and physical therapy with biofeedback to lower the muscle tension in the pelvic floor for vulvar vestibulitis.
*Typical therapies include [[Estrogen Vaginal|topical estrogen cream]], low-dose pain medications, and physical therapy with biofeedback to lower the muscle tension in the pelvic floor for vulvar vestibulitis.
*Medication or surgical procedures may be needed to control or remove abnormal growths of uterine tissue in endometriosis.
*Medication or surgical procedures may be needed to control or remove abnormal growths of uterine tissue in [[endometriosis]].
*For [[dyspareunia]] that has no apparent physical cause or has lasted for months or years, may need psychological counseling to address stress or anxiety regarding sexual intercourse. If a medical cause is successfully treated and pain has not been resolved yet, a diagnosis of [[vulvodynia]] or '''genito-pelvic/penetration disorder''' is appropriate.<br>
*For [[dyspareunia]] that has no apparent physical cause or has lasted for months or years, may need psychological counseling to address stress or anxiety regarding sexual intercourse. If a medical cause is successfully treated and pain has not been resolved yet, a diagnosis of [[vulvodynia]] or '''genito-pelvic/penetration disorder''' is appropriate.<br>


'''In men'''<br>
'''In men'''<br>
The medical treatment of dyspareunia in men depends upon the cause.
The medical treatment of dyspareunia in men depends upon the cause.
*Anti-allergic medication might be prescribed  if there is an allergic reaction to a particular brand of condom or spermicide  
*Anti-allergic medication might be prescribed  if there is an [[allergic reaction]] to a particular brand of [[condom]] or [[spermicide]]
*Trim its threads so that they do not protrude far through the cervix if the pain is caused by the partner’s intrauterine contraceptive device that protrudes from the cervix
*Trim its threads so that they do not protrude far through the [[cervix]] if the pain is caused by the partner’s [[Intrauterine device|intrauterine contraceptive device]] that protrudes from the [[cervix]]
*Antibiotics might be prescribed  if the infection is the cause of dyspareunia for both patient and his partner
*[[Antibiotics]] might be prescribed  if the infection is the cause of [[dyspareunia]] for both patient and his partner
*If no physical cause is found to be causing the pain, refer the patient to a sex therapist, and a counselor who can help him to work through any psychological problems together with his partner.


===Non-Medical treatment:===
===Non-Medical treatment:===
Education about vulvar self-care, including avoidance of douch-es, possible irritants, and allergens, is an important first step for practitioners [8]. Knowledge of genital anatomy and the female sexual response cycle may also be beneficial to facilitate a greater understanding of what to expect from sexual encounters and to reduce anxiety. Psychological intervention,  often in the form of  CBT,  aims to explore a  woman’s thoughts,  emotions, behaviors, and relationship dynamics associated with the experience of her sexual pain.<br>
Education about vulvar self-care, including avoidance of douch-es, possible irritants, and allergens, is an important first step for practitioners. Knowledge of genital anatomy and the female sexual response cycle may also be beneficial to facilitate a greater understanding of what to expect from [[sexual]] encounters and to reduce [[anxiety]]. [[Psychological]] intervention,  often in the form of  [[CBT]],  aims to explore a  patient’s thoughts,  emotions, behaviors, and relationship dynamics associated with the experience of sexual pain.<br>


==References==
==References==

Latest revision as of 18:40, 22 September 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Vishnu Vardhan Serla M.B.B.S. [2]

Overview

The mainstay of treatment for dyspareunia is the treatment of the underlying cause. Non-Medical treatment also should be considered. Psychological intervention, often in the form of CBT can be helpful.

Medical Therapy

The medical treatment of dyspareunia depends upon the cause.[1]

In men
The medical treatment of dyspareunia in men depends upon the cause.

Non-Medical treatment:

Education about vulvar self-care, including avoidance of douch-es, possible irritants, and allergens, is an important first step for practitioners. Knowledge of genital anatomy and the female sexual response cycle may also be beneficial to facilitate a greater understanding of what to expect from sexual encounters and to reduce anxiety. Psychological intervention, often in the form of CBT, aims to explore a patient’s thoughts, emotions, behaviors, and relationship dynamics associated with the experience of sexual pain.

References