Dyspareunia, or painful sexual intercourse, is a common symptom among women.
The prevalence of dyspareunia varies widely depending on the population being sampled and how it is defined. Systematic reviews report dyspareunia prevalence ranging from 8% to 35%. One UK survey found that painful sex was reported by 7.5% of sexually active women. In the US, dyspareunia is estimated to affect 10% to 20% of women.
Dyspareunia and vaginismus have been grouped as genito-pelvic pain/penetration disorder in DSM-5-TR. This is categorised as persistent or recurrent difficulty in vaginal penetration; marked pelvic or vulvovaginal pain during or while attempting penetration; fear or anxiety about pain before, during, or after penetration; and tightening or tensing of the pelvic floor muscles when penetration is attempted. The DSM-5-TR criteria specify that symptoms must have been present for approximately 6 months, be causing the patient clinically significant distress, and not be better explained by a non-sexual mental disorder or a consequence of relationship distress or other significant stressors.
Dyspareunia can be categorised as primary or secondary; as well as superficial or deep:
Primary dyspareunia is characterised by pain associated with intercourse since the onset of sexual activity.
Secondary dyspareunia is acquired over a patient's sexual lifetime.
Painful intercourse that is localised to the introital area is characteristic of superficial dyspareunia, due to disorders of the vulva and vestibule.
Deep symptoms are often related to disorders in the pelvis.
- Vaginitis and vulvovaginitis
- Herpes simplex infection
- Vaginal atrophy
- Primary inadequate lubrication
- Interstitial cystitis
- Urinary tract infection
- Bartholin's gland abscess
- Seminal plasma hypersensitivity
- Contact dermatitis
- Atopic dermatitis
- Bartholin's gland mass
- Imperforate hymen
- Traumatic perineal injuries
- Vulvar dystrophies
- Psychosexual disorder
- Pelvic inflammatory disease
- Levator ani spasm
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