Dyspareunia and vulvar disease

To determine the presence and frequency of contributing factors in functional dyspareunia and if these factors differ between patients with an epithelial disorder and those with apparently healthy genitalia.

A psychologist assessed patients reporting dyspareunia at a vulvar diseases clinic by using a structured interview questionnaire, the Beck Depression Inventory, and the Spielberger State/Trait Anxiety Inventory. The questionnaire topics included sexual behavior, stresses and coping. Data were divided into two groups based on patients' functional diagnosis or epithelial disorder.

Both groups recorded high levels of trauma-producing sexual behavior. Such behavior included unlubricated, unaroused and undesired sex. High levels of psychological and coping difficulties were also seen. Differences between the groups were seen in undesired sex, capacity to cope, stress factors coincidental with symptom onset and distress at the time of interview.

Due to the high frequency of factors contributing to dyspareunia, such factors should be address regardless of the diagnosis. In all such patients it is recommended that a sexual and stress history be taken and counseling be considered.