Dyspareunia in Women

Area of Science:

• Women's Health
• Sexual Medicine
• Gynecology

Background:

• Dyspareunia is recurrent or persistent pain during sexual intercourse, affecting 10-20% of U.S. women.
• This condition can be superficial or deep and is associated with increased risks of sexual dysfunction, relationship distress, anxiety, and depression.

Purpose of the Study:

• To outline the diagnostic approach to dyspareunia.
• To review common causes and treatment options for dyspareunia.

Main Methods:

• Clinical assessment involves creating a safe environment for taking a sexual history.
• Physical examination includes external genitalia inspection, cotton swab testing, single-digit vaginal examination, and bimanual examination.

Main Results:

• Common diagnoses include vulvodynia, inadequate lubrication, vaginal atrophy, postpartum causes, pelvic floor dysfunction, endometriosis, and vaginismus.
• Treatment strategies are cause-specific and may involve lubricants, physical therapy, topical analgesics, vaginal estrogen, cognitive behavior therapy, dilators, vestibulectomy, or onabotulinumtoxinA injections.

Conclusions:

• Effective management of dyspareunia requires a comprehensive diagnostic evaluation to identify underlying causes.
• A range of treatments, from conservative measures to surgical interventions, can address the diverse etiologies of painful intercourse.