Dyspareunia classification: Difference between revisions

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{{CMG}} {{AE}}
{{CMG}} {{AE}}
==Overview==
==Overview==
It may be classified into two types in women: [[superficial]], which occurs in or around the vaginal entrance, and is characterized by initial discomfort in initial or attempted penetration of the vaginal introitus. Deep dyspareunia is a pain that occurs with deep [[vaginal]] penetration. which resulting from pelvic thrusting during intercourse. Causes are divided into three groups according to Onset, Frequency as well. Based on the onset, [[dyspareunia]] can be divided into two groups based on the onset in women: Primary (onset with first sexual experience) Often has psychological causes, such as sexual abuse in childhood, feeling of guilt or shame toward sex, or fear of intercourse or painful first intercourse, and secondary dyspareunia that its beginning is after a previous sexual activity that was not painful. Dyspareunia can be Persistent, which occurs in all situations, possibly due to physical or psychological factors, or conditional dyspareunia that occurs in certain situations. Abdomino-pelvic disorders such as [[endometriosis]], [[imperforate hymen]], [[vaginal septum]], or organic [[vulvodynia]] due to infection, [[Lichen sclerosus|lichen sclerosis]], or vestibulitis, vaginal infections, [[prolapse]], [[trauma]], or vaginal dryness can cause [[dyspareunia]]. It can also be due to [[gastrointestinal disorders]] such as [[chronic constipation]], diverticular diseases, [[inflammatory bowel disease]]/[[proctitis]]. Scarring due to previous pelvic surgery, [[episiotomy]], and perineorraphy, or urological causes such as [[cystitis]], [[interstitial cystitis]], or [[urethritis]] can cause [[dyspareunia]] as well. Male [[dyspareunia]] is divided into broad categories of underlying causes ranging from [[anatomic]] anomalies to [[psychosocial]] problems. Male dyspareunia is related to the following anatomical structures: 1) [[prepuce]], 2) [[glans penis]], 3) penile shaft, 4) [[testicles]], and 5) [[urethra]] and [[prostate gland]]. Another classification system defines four broad categories: Isolated painful [[ejaculation]], [[Chronic prostatitis/chronic pelvic pain syndrome|Chronic prostatitis/chronic pelvic pain]], [[Medical]] causes, [[psychological]] causes.
Dyspareunia may be classified into different types based on its location, onset, and frequency in women. Male [[dyspareunia]] is divided into broad categories of underlying causes ranging from [[anatomic]] anomalies to [[psychosocial]] problems.


==Dyspareunia classifctaion==
==Dyspareunia classifctaion==
===Dyspareunia in female===
===Dyspareunia in female===
*Dyspareunia and vaginismus have been grouped as genito-pelvic pain/penetration disorder in DSM-5. This is defined as persistent or recurrent difficulty in vaginal penetration, marked pelvic or vulvovaginal pain during or while attempting penetration, fear or anxiety about pain before, during, or after penetration, and tightening or tensing of the pelvic floor muscles when penetration is attempted.<ref>https://doi.org/10.18192/uojm.v7i2.2198</ref>
 
Dyspareunia may be classified into 2 type: superficial and deep  based on its location:  
*Based on [[DSM|Diagnosis Statistical Manual of Mental Disorders]] (DSM-5; American Psychiatric Association, 2013),[[dyspareunia]] and [[vaginismus]] were typically classified as distinct [[sexual pain disorders]]. This new classification unifies [[vaginismus]] and [[dyspareunia]] into one category called “genito-pelvic pain/penetration disorder” due to the clinical difficulties in distinguishing these conditions because, in practice, it is difficult to differentiate these two from each other. Sometimes the pain may cause [[pelvic]] [[muscle spasms]] or [[involuntary]] [[pelvic]] [[muscle spasm]]s in [[vaginismus]] to cause pain. GPPPD is an umbrella term for two sexual pain disorders:[[dyspareunia]] and [[vaginismus]]. However, possible medical causes of [[dyspareunia]] should be ruled out or treated before considering a [[diagnosis]] of Genito-Pelvic Pain/Penetration Disorder (GPPPD). 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.<ref>https://doi.org/10.18192/uojm.v7i2.2198</ref>
*[[Superficial]], which occurs in or around the [[vaginal]] entrance, and is characterized by initial discomfort in initial or attempted penetration of the vaginal introitus. Commonly found in:
 
*Deep dyspareunia is a pain that occurs with deep vaginal penetration, which results from pelvic thrusting during [[intercourse]]. Conditions are associated with deep dyspareunia are:
[[Dyspareunia]] may be classified into 2 type: [[superficial]] and deep  based on its location:  
**Chronic pelvic pain
 
**Endometriosis
*[[Superficial]], which occurs in or around the [[vaginal]] entrance, and is characterized by initial discomfort in initial or attempted [[penetration]] of the [[vaginal]] introitus. Commonly found in:
**Chronic PID
*Deep [[dyspareunia]] is a [[pain]] that occurs with deep [[vaginal]] penetration, which results from pelvic thrusting during [[intercourse]]. Conditions are associated with deep dyspareunia are:
**[[Chronic pelvic pain]]
**[[Endometriosis]]
**[[Chronic PID]]
 
It may be classified into 2 type: primary and secondary based on its onset:
It may be classified into 2 type: primary and secondary based on its onset:
*Primary (onset with first sexual experience) Often has [[psychological]] causes, such as [[Sexual assault|sexual abuse]] in childhood, feeling of guilt or shame toward sex or fear of [[intercourse]] or painful first intercourse
 
*Secondary dyspareunia that its beginning is after a previous [[sexual]] activity that was not painful.<br>  
*Primary (onset with first [[sexual]] experience) Often has [[psychological]] causes, such as [[Sexual assault|sexual abuse]] in childhood, feeling of guilt or [[shame]] toward sex or fear of [[intercourse]] or [[painful]] first [[intercourse]].
Dyspareunia can be classified into 2 types: persistent or conditional, based on its frequency:
*Secondary [[dyspareunia]] that its beginning is after a previous [[sexual]] activity that was not [[painful]].<br>
*Persistent which occurs in all situations, possibly due to physical or psychological factors
 
*Conditional dyspareunia that occurs in certain situations.  
[[Dyspareunia]] can be classified into 2 types: [[persistent]] or [[conditional]], based on its frequency:
 
*Persistent which occurs in all situations, possibly due to [[physica]]l or [[psychological]] factors.
*Conditional [[dyspareunia]] that occurs in certain situations.Abdomino-pelvic disorders such as [[endometriosis]], [[imperforate hymen]], [[vaginal septum]], or organic [[vulvodynia]] due to infection, [[Lichen sclerosus|lichen sclerosis]], or vestibulitis, vaginal infections, [[prolapse]], [[trauma]], or vaginal dryness can cause [[dyspareunia]]. It can also be due to [[gastrointestinal disorders]] such as [[chronic constipation]], diverticular diseases, [[inflammatory bowel disease]]/[[proctitis]]. Scarring due to previous pelvic surgery, [[episiotomy]], and perineorraphy, or urological causes such as [[cystitis]], [[interstitial cystitis]], or [[urethritis]] can cause [[dyspareunia]] as well. Male [[dyspareunia]] is divided into broad categories of underlying causes ranging from [[anatomic]] anomalies to [[psychosocial]] problems. Male dyspareunia is related to the following anatomical structures: 1) [[prepuce]], 2) [[glans penis]], 3) penile shaft, 4) [[testicles]], and 5) [[urethra]] and [[prostate gland]]. Another classification system defines four broad categories: Isolated painful [[ejaculation]], [[Chronic prostatitis/chronic pelvic pain syndrome|Chronic prostatitis/chronic pelvic pain]], [[Medical]] causes, [[psychological]] causes.
 
===Dyspareunia in male===
===Dyspareunia in male===
Male dyspareunia may be classified into broad categories.It may classified into 5 tysubtypes based on [[anatomic]] anomalies:<br>
Male dyspareunia may be classified into broad categories. It may be classified into 5 subtypes based on [[anatomic]] anomalies:<br>
(1) [[prepuce]]<br>
(1) [[prepuce]]<br>
(2) [[glans penis]]<br>
(2) [[glans penis]]<br>
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(5) [[urethra]] and [[prostate gland]]<br>
(5) [[urethra]] and [[prostate gland]]<br>
Another classification system defines four broad categories for male dyspareunia:
Another classification system defines four broad categories for male dyspareunia:
*Isolated painful ejaculation
 
*Isolated painful [[ejaculation]]
*[[Chronic prostatitis/chronic pelvic pain syndrome|Chronic prostatitis/chronic pelvic pain]]
*[[Chronic prostatitis/chronic pelvic pain syndrome|Chronic prostatitis/chronic pelvic pain]]
*Medical causes
*Medical causes

Latest revision as of 00:29, 10 October 2020

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

Overview

Dyspareunia may be classified into different types based on its location, onset, and frequency in women. Male dyspareunia is divided into broad categories of underlying causes ranging from anatomic anomalies to psychosocial problems.

Dyspareunia classifctaion

Dyspareunia in female

Dyspareunia may be classified into 2 type: superficial and deep based on its location:

It may be classified into 2 type: primary and secondary based on its onset:

Dyspareunia can be classified into 2 types: persistent or conditional, based on its frequency:

Dyspareunia in male

Male dyspareunia may be classified into broad categories. It may be classified into 5 subtypes based on anatomic anomalies:
(1) prepuce
(2) glans penis
(3) penile shaft
(4) testicles
(5) urethra and prostate gland
Another classification system defines four broad categories for male dyspareunia:

References