Dyspareunia

Published on 10/03/2015 by admin

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Last modified 10/03/2015

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Chapter 11 DYSPAREUNIA

Dyspareunia is recurrent genital pain during or after sexual intercourse. The pain may occur in the more superficial structures, such as the vulva, or deeper in the pelvic structures. Although dyspareunia occurs in both men and women, it is more prevalent in women. Dyspareunia may occur in as many as 60% of women, although far fewer seek medical care for this problem. Dyspareunia often has multiple causes, including both physical and psychologic causes.

Patients with dyspareunia may complain of a well-defined and localized pain, or they may express a general disinterest in and dissatisfaction with intercourse that results from the associated discomfort. The most common pain with dyspareunia occurs during coitus, but some women experience pain afterward, and others report pain at both times. Dyspareunia is differentiated from vaginismus and from problems resulting from inadequate lubrication.

The Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), defines dyspareunia as a sexual pain disorder, a subcategory of sexual dysfunction. However, the biopsychosocial approach emphasizes that physical and psychologic factors may be instigating causes and reasons for perpetuation of the symptoms. The causes of women’s sexual pain differ for each subtype of pain, with substantial overlap between types of pain. What remains the most unclear is the cause of the original sensitization.

Medications Linked to Dyspareunia

Bromocriptine mesylate (which can cause painful clitoral tumescence)

Desipramine hydrochloride (which can cause painful orgasm)

Letrozole (which can cause vaginal dryness)

Risperidone (which can cause vaginal dryness)

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