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Dyspareunia
Dyspareunia (/dɪspərˈuniə/ dis-pər-OO-nee-ə) is painful sexual intercourse due to somatic or psychological causes. Although the word dyspareunia includes both female and male patients, discussions that use the term without specifying the patient's sex usually concern the female type, which is the more common.[citation needed]
In females, the pain may primarily affect the external surface of the genitalia (the vulva or vagina) or may be deeper in the pelvis from pressure against the cervix. Dyspareunia is a pelvic floor dysfunction that is often underdiagnosed. Understanding the duration, location, and nature of the pain is important in diagnosing the causes.
In 2020, dyspareunia was estimated to affect 35% of women worldwide at some point in their lives. Numerous physical, psychological, and social or relationship factors can contribute to pain during sexual encounters. Often, multiple underlying causes contribute to the pain. The pain can be acquired or congenital. Symptoms of dyspareunia may also occur after menopause.[citation needed]
Diagnosis is typically by physical examination and medical history. In each case, underlying causes determine treatment. Many patients achieve relief when physical causes are identified and treated.[citation needed]
Those who experience pelvic pain upon attempted vaginal intercourse describe their pain in many ways. This reflects how many different and overlapping causes there are for dyspareunia. The location, nature, and time course of the pain help to understand potential causes and treatments.
Some describe superficial pain at the opening of the vagina or surface of the genitalia when penetration is initiated. Others feel deeper pain in the vault of the vagina or deep within the pelvis upon deeper penetration. Some feel pain in more than one of these places. Determining whether the pain is more superficial or deep is important in understanding what may be causing the pain. Some patients have always experienced pain with intercourse from their very first attempt, while others begin to feel pain with intercourse after an injury or infection or cyclically with menstruation. Sometimes the pain increases over time.[citation needed]
Pain may distract from feeling pleasure and excitement. Both vaginal lubrication and vaginal dilation decrease. When the vagina is dry and undilated, penetration is more painful. Fear of being in pain can make the discomfort worse. Pain may continue despite the original source being removed, due to the learned expectation of pain. Fear, avoidance, and psychological distress around attempting intercourse can become large parts of the experience of dyspareunia.
Physical examination of the vulva (external genitalia) may reveal clear reasons for pain including lesions, thin skin, ulcerations or discharge associated with vulvovaginal infections or vaginal atrophy. An internal pelvic exam may also reveal physical reasons for pain including lesions on the cervix or anatomic variation.
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Dyspareunia
Dyspareunia (/dɪspərˈuniə/ dis-pər-OO-nee-ə) is painful sexual intercourse due to somatic or psychological causes. Although the word dyspareunia includes both female and male patients, discussions that use the term without specifying the patient's sex usually concern the female type, which is the more common.[citation needed]
In females, the pain may primarily affect the external surface of the genitalia (the vulva or vagina) or may be deeper in the pelvis from pressure against the cervix. Dyspareunia is a pelvic floor dysfunction that is often underdiagnosed. Understanding the duration, location, and nature of the pain is important in diagnosing the causes.
In 2020, dyspareunia was estimated to affect 35% of women worldwide at some point in their lives. Numerous physical, psychological, and social or relationship factors can contribute to pain during sexual encounters. Often, multiple underlying causes contribute to the pain. The pain can be acquired or congenital. Symptoms of dyspareunia may also occur after menopause.[citation needed]
Diagnosis is typically by physical examination and medical history. In each case, underlying causes determine treatment. Many patients achieve relief when physical causes are identified and treated.[citation needed]
Those who experience pelvic pain upon attempted vaginal intercourse describe their pain in many ways. This reflects how many different and overlapping causes there are for dyspareunia. The location, nature, and time course of the pain help to understand potential causes and treatments.
Some describe superficial pain at the opening of the vagina or surface of the genitalia when penetration is initiated. Others feel deeper pain in the vault of the vagina or deep within the pelvis upon deeper penetration. Some feel pain in more than one of these places. Determining whether the pain is more superficial or deep is important in understanding what may be causing the pain. Some patients have always experienced pain with intercourse from their very first attempt, while others begin to feel pain with intercourse after an injury or infection or cyclically with menstruation. Sometimes the pain increases over time.[citation needed]
Pain may distract from feeling pleasure and excitement. Both vaginal lubrication and vaginal dilation decrease. When the vagina is dry and undilated, penetration is more painful. Fear of being in pain can make the discomfort worse. Pain may continue despite the original source being removed, due to the learned expectation of pain. Fear, avoidance, and psychological distress around attempting intercourse can become large parts of the experience of dyspareunia.
Physical examination of the vulva (external genitalia) may reveal clear reasons for pain including lesions, thin skin, ulcerations or discharge associated with vulvovaginal infections or vaginal atrophy. An internal pelvic exam may also reveal physical reasons for pain including lesions on the cervix or anatomic variation.