Recurrent or persistent
genital pain, associated with sexual intercourse in either a male
or a female). In women, it is generally defined as genital pain occurring
with penetration or during or after intercourse but not exclusively
vaginismus (a common type of
insertional dyspareunia caused by intense involuntary contraction
of the perineal muscles surrounding the outer one third of the vagina).
True dyspareunia is recurrent and associated with a disruption of
normal functioning. The disturbance causes marked distress or interpersonal
difficulty. The disturbance is not caused exclusively by
vaginismus or lack of lubrication. Diagnostic criteria is as follows:
The patient often experiences genital pain with sexual intercourse.
It is due neither to Vaginismus
nor inadequate lubrication.
Except for another Sexual
Dysfunction.
It is not directly caused by substance use (medication or drug of
abuse) or by a general medical condition.
It causes marked distress or interpersonal problems.
Associated
Features:
Vaginismus
Cause:
Dyspareunia is
a symptom of multiple and varied disease states and may have multiple
causes with components of both organic and psychiatric dysfunction.
Women with dyspareunia
were found to have more physical pathology and greater psychological
symptoms. They reported more negative attitudes toward sexuality,
higher levels of sexual impairment, and lower levels of marital adjustment,
but they did not report more physical or sexual abuse, either past
or present. Subjects with the greatest psychological symptoms and
marital maladjustment had no discernible physical findings on examination,
and their levels of sexual function were similar to those of matched
controls.
Treatment:
Depending on your history, the results of a medical exam and other
diagnostic tests treatment for dspareunia may include some of the
following options:
Counseling
and Psychotherapy [ See
General Therapy Section & Sex
Therapy ]:
Relaxation exercises
may help a woman regain control over vaginal muscles, reducing pain
and making sexual intercourse more pleasurable.
Medical
& Other:
Position
Change: In the case of a tipped uterus, a change in position
may allow the uterus to move and result in more comfortable intercourse.
Medications:
In the case of an infection, treatment with medication often solves
the problem.
Lubrication:
Use of a cream or jelly can help make sexual intercourse more comfortable
in cases when there is not enough natural lubrication.
