Dyspareunia

Chapter 11 DYSPAREUNIA



Kathleen Dor


Dyspareunia is recurrent genital pain during or after sexual intercourse. The pain may occur in the more superficial structures, such as the vulva, or deeper in the pelvic structures. Although dyspareunia occurs in both men and women, it is more prevalent in women. Dyspareunia may occur in as many as 60% of women, although far fewer seek medical care for this problem. Dyspareunia often has multiple causes, including both physical and psychologic causes.


Patients with dyspareunia may complain of a well-defined and localized pain, or they may express a general disinterest in and dissatisfaction with intercourse that results from the associated discomfort. The most common pain with dyspareunia occurs during coitus, but some women experience pain afterward, and others report pain at both times. Dyspareunia is differentiated from vaginismus and from problems resulting from inadequate lubrication.


The Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), defines dyspareunia as a sexual pain disorder, a subcategory of sexual dysfunction. However, the biopsychosocial approach emphasizes that physical and psychologic factors may be instigating causes and reasons for perpetuation of the symptoms. The causes of women’s sexual pain differ for each subtype of pain, with substantial overlap between types of pain. What remains the most unclear is the cause of the original sensitization.



Medications Linked to Dyspareunia




Bromocriptine mesylate (which can cause painful clitoral tumescence)


Cevimeline


Desipramine hydrochloride (which can cause painful orgasm)


Goserelin


Letrozole (which can cause vaginal dryness)


Leuprolide


Risperidone (which can cause vaginal dryness)



Causes of Dyspareunia




Anxiety


Arousal disorders


Bartholin gland abscess


Behçet syndrome


Bladder neoplasm


Breastfeeding


Cervical cancer


Chronic constipation


Contact dermatitis


Depression


Diverticular disease


Endometriosis


Endometritis


Hemorrhoids


Herpes infection


Hymenal stenosis


Hypertrophic vulvar dystrophy


Inadequate vaginal lubrication


Inflammatory bowel disease


Interstitial cystitis


Lichen sclerosis


Medications


Ovarian cysts


Ovarian neoplasms


Ovarian remnant syndrome


Pelvic congestion syndrome


Pelvic inflammatory disease


Postpartum dyspareunia

Related posts:

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  2. Hypertension during pregnancy
  3. Precocious puberty
  4. Vaccinations during pregnancy

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Jun 4, 2016 | Posted by in GYNECOLOGY | Comments Off on Dyspareunia

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