title: Dyspareunia in women.
abstract: Dyspareunia is recurrent or persistent pain with sexual activity that causes marked distress or interpersonal conflict. It affects approximately 10% to 20% of U.S. women. Dyspareunia can have a significant impact on a woman's mental and physical health, body image, relationships with partners, and efforts to conceive. The patient history should be taken in a nonjudgmental way and progress from a general medical history to a focused sexual history. An educational pelvic examination allows the patient to participate by holding a mirror while the physician explains normal and abnormal findings. This examination can increase the patient's perception of control, improve self-image, and clarify findings and how they relate to discomfort. The history and physical examination are usually sufficient to make a specific diagnosis. Common diagnoses include provoked vulvodynia, inadequate lubrication, postpartum dyspareunia, and vaginal atrophy. Vaginismus may be identified as a contributing factor. Treatment is directed at the underlying cause of dyspareunia. Depending on the diagnosis, pelvic floor physical therapy, lubricants, or surgical intervention may be included in the treatment plan.
authors.affiliation: Eisenhower Army Medical Center, Fort Gordon, GA, USA.
authors.forename: Dean A
authors.initials: DA
authors.lastname: Seehusen
authors.affiliation: Carl R. Darnall Army Medical Center, Fort Hood, TX, USA.
authors.forename: Drew C
authors.initials: DC
authors.lastname: Baird
authors.affiliation: Eisenhower Army Medical Center, Fort Gordon, GA, USA.
authors.forename: David V
authors.initials: DV
authors.lastname: Bode
mesh_terms: D003937:Diagnosis, Differential; D004414:Dyspareunia / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D016387:Women's Health