Evaluation of dyspareunia

Dyspareunia, or painful sexual intercourse, is a common complaint among women.

Epidemiology

The prevalence of dyspareunia varies widely depending on the population being sampled and how it is defined. Retrospective studies have cited a range from 1.5% to 70%. [1] Jamieson DJ, Steege JF. The prevalence of dysmenorrhea, dyspareunia, pelvic pain, and irritable bowel syndrome in primary care practices. Obstet Gynecol. 1996;87:55-58. http://www.ncbi.nlm.nih.gov/pubmed/8532266?tool=bestpractice.com [2] Glatt AE, Zinner SH, McCormack WM. The prevalence of dyspareunia. Obstet Gynecol. 1990;75:433-436. http://www.ncbi.nlm.nih.gov/pubmed/2304713?tool=bestpractice.com [3] Sobhgol SS, Alizadeli Charndabee SM. Rate and related factors of dyspareunia in reproductive age women: a cross-sectional study. Int J Imp Res. 2007;19:88-94. http://www.ncbi.nlm.nih.gov/pubmed/16791280?tool=bestpractice.com [4] Danielsson I, Sjoberg I, Stenlund H, et al. Prevalence and incidence of prolonged and severe dyspareunia in women: results from a population study. Scand J Public Health. 2003;31:113-118. http://www.ncbi.nlm.nih.gov/pubmed/12745761?tool=bestpractice.com [5] Frank RT. Dyspareunia: a problem for the general practitioner. JAMA. 1948;136:361. [6] Hansen A, Carr K, Jensen JT. Characteristics and initial diagnoses in women presenting to a referral center for vulvovaginal disorders in 1996-2000. J Reprod Med. 2002;47:854-860. http://www.ncbi.nlm.nih.gov/pubmed/12418071?tool=bestpractice.com A survey of women at primary care clinics reported that 46% of women had experienced painful intercourse, [1] Jamieson DJ, Steege JF. The prevalence of dysmenorrhea, dyspareunia, pelvic pain, and irritable bowel syndrome in primary care practices. Obstet Gynecol. 1996;87:55-58. http://www.ncbi.nlm.nih.gov/pubmed/8532266?tool=bestpractice.com whereas another survey of university alumni who had participated in a sexually transmitted infection study during college found a lifetime prevalence of 61%. [2] Glatt AE, Zinner SH, McCormack WM. The prevalence of dyspareunia. Obstet Gynecol. 1990;75:433-436. http://www.ncbi.nlm.nih.gov/pubmed/2304713?tool=bestpractice.com

Classification

Dyspareunia can be categorized as primary or secondary; as well as superficial or deep. [7] MacNeill C. Dyspareunia. Obstet Gynecol Clin N Am. 2006;33:565-577. http://www.ncbi.nlm.nih.gov/pubmed/17116501?tool=bestpractice.com

• Primary dyspareunia is characterized 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 localized 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.