Dyspareunia resident survival guide
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Roghayeh Marandi
Overview
Dyspareunia is recurrent or persistent pain with sexual activity that causes marked distress or interpersonal conflict. It can affect men, but more common in women. It can due to psychological factors, physical factors, or combined factors. 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 pain that occurs with deep vaginal penetration. which resulting from pelvic thrusting during intercourse. Causes are divided into three groups according to Onset, Frequency, or Location. According to Dyspareunia's location, there are two types of Dyspareunia in women: superficial, which occurs in or around the vaginal entrance, and is characterized by early discomfort in initial or attempted penetration of the vaginal introitus, and deep Dyspareunia is pain that occurs with deep vaginal penetration, Which resulting from pelvic thrusting during intercourse. Determining whether Dyspareunia is the entry or deep can point to specific causes. Based on the onset, Dyspareunia can be divided into two groups: 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 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.
Causes
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
Common Causes
- Vaginitis
- Hormonal changes perimenopause and menopause
- Vaginismus
- Pelvic inflammaatory disease
- Vulvodynia
- Endometriosis
Diagnosis
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Treatment
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Do's
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Don'ts
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