Dyspareunia medical therapy
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Treatment |
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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
It depends on the underlying cause and subsequent therapy(see table below for details). Educate patients about pelvic anatomy, physiology, and lifestyle modification.
Medical Therapy
Dyspareunia is treated by taking the following steps:
- Carefully taking a history.
- Carefully examining the pelvis to duplicate as closely as possible the discomfort and to identify a site or source of the pelvic pain.
- Clearly explaining to the patient what has happened, including identifying the sites and causes of pain.
- Removing the source of pain when possible. Treatment depends on the cause of dyspareunia. for example, 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.For vaginal yeast infections, you will be given antifungal medication.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.For atrophic vaginitis, estrogen therapy will be prescribed, either as a vaginal formulation or as a pill.For skin diseases affecting the vaginal area, the treatment will vary depending on the disease. For example, lichen sclerosus and lichen planus often improve with steroid creams.For vulvar vestibulitis, typical therapies include topical estrogen cream, low-dose pain medications, and physical therapy with biofeedback to lower the muscle tension in the pelvic floor.If endometriosis may be prescribed medication or may need surgical procedures to control or remove abnormal growths of uterine tissue.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.