What is Dyspareunia?

Dyspareunia is persistent or recurrent genital pain that occurs before during or after intercourse. Causes may be physical or psychological in origin. A thorough patient history, pelvic exam and sometimes imaging such as ultrasound or CT may be utilized to determine the cause.

Symptoms vary depending on the origin or the pain. Pain may occur upon entry or with shallow penetration. This may be due to vulvar vestibulitis, trauma, inadequate lubrication or muscle spasms.

Pain may also occur with deep penetration. This may be alleviated by changing positions or can be more persistent or bothersome, requiring treatment. Deep dyspareunia may be caused by pelvic conditions such as fibroids, ovarian cysts, previous surgeries, prolapse, endometriosis, or retroverted uterus.

Treatment for dyspareunia is targeted to treat the underlying cause for the symptoms. This may include behavioral changes, discontinuation of irritating products, pelvic floor physical therapy, vaginal stimulators, or surgery. Surgical repair may include vestibulectomy in cases of vestibulitis or vaginal prolapse repair or Sacrocolpopexy in cases of prolapse. Treatment for deep dyspareunia is directed to treatment of the underlying pelvic condition.

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