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.
