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Dyspareunia

Scott T. Henderson, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Recurrent and persistent genital pain is associated with sexual activity, which is not exclusively due to lack of lubrication or vaginismus, and is associated with distress or interp...

DIAGNOSIS

HISTORY

  • Identify pain characteristics:

    • Onset

    • Duration

    • Location: entry versus deep, single versus multiple sites; positional

    • Intensity/quality: varying degrees of pelvic/genital pressure, aching...

TREATMENT

  • Potential relationships exists between primary dyspareunia and vaginismus, low libido, and arousal disorders.

  • Endocrine factors, such as primary amenorrhea, might reduce the biologic basis of...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

  • Outpatient follow-up depends on therapy.

  • Every 6 to 12 months once resolved

DIET

A high-fiber diet may help if constipation is a contributing cause...

REFERENCES

1
1 Crowley T, Richardson D, Goldmeier D. Recommendations for the management of vaginismus: BASHH Special Interest Group for Sexual Dysfunction. Int J STD AIDS.  2006;17(1):14–18. {L-En...

ADDITIONAL READING

  • Seehusen DA, Baird DC, Bode DV. Dyspareunia in women. Am Fam Physician.  2014;90(7):465–470. {L-End} {L-End} [View Abstract on OvidMedline]

  • Sung SC, Jeng CJ, Lin YC. Sexual h...

SEE ALSO

  • Balanitis, Phimosis, and Paraphimosis; Endometriosis; Genito-Pelvic Pain/Penetration Disorder (Vaginismus); Pelvic Inflammatory Disease (PID); Sexual Dysfunction in Women; Vulvovaginitis, Est...

CODES

ICD10

  • N94.1 Dyspareunia

  • F52.6 Dyspareunia not due to a substance or known physiol cond

ICD9

  • 625.0 Dyspareunia

  • 302.76 Dyspareunia, psychogenic

SNOMED

  • 71315007 Dyspareunia (finding)

  • 41021005 Psychologic d...

CLINICAL PEARLS

  • Careful history to determine if patient feels pain before, during, or after intercourse will help identify cause.

    • Pain before intercourse suggests a phobic attitude toward penetration...

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