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. Retrospective studies have cited a range from 1.5% to 70%. A survey of women at primary care clinics reported that 46% of women had experienced painful intercourse, whereas another survey of university alumni who had participated in a sexually transmitted infection study during college found a lifetime prevalence of 61%.
Dyspareunia can be categorized as primary or secondary; as well as superficial or deep.
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.
Dyspareunia and vaginismus have been grouped as genito-pelvic pain/penetration disorder in DSM-5. This is categorized 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.
- Interstitial cystitis
- Urinary tract infections, female
- Bartholin gland abscess
- Seminal plasma hypersensitivity
- Dermatitis, contact
- Dermatitis, atopic
- Bartholin gland mass
- Imperforate hymen
- Traumatic perineal injuries
- Vulvar dystrophies
- Psychosexual disorder
- Pelvic inflammatory disease
- Levator ani spasm
Kai J. Buhling, MD, PhD
Head of Department of Gynecological Endocrinology and Reproductive Medicine
University Hospital Hamburg-Eppendorf
KJB declares that he has no competing interests.
Dr Buhling would like to gratefully acknowledge Dr Hans-Joachim Ahrendt, Dr Suketu M. Mansuria and Dr Amy N. Broach, the previous contributors to this topic. SMM declares that he has no competing interests.
Lori A. Brotto, PhD, R Psych
Department of Obstetrics and Gynecology
University of British Columbia
LAB declares that she has no competing interests.
Katherine E. Bunge, MD
University of Pittsburgh
KEB declares that she has no competing interests.
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