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Dyspareunia

Scott T. Henderson, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

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

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

GENERAL MEASURES

  • Educate the patient and partner regarding the nature of the problem. Reassure both that there are solutions to the problem.

  • Initiate specific treatment when initial evaluation...

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
Weinberger JM, Houman J, Caron AT, et al. Female sexual dysfunction: a systematic review of outcomes across various treatment modalities [published online ahead of print February 3, 2018]....

ADDITIONAL READING

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

  • Sorensen J, Bautista KE, Lamvu G, et al. Evaluation a...

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 a...

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