Dyspareunia

Lore & Background

Dyspareunia encompasses pain during sexual intercourse, with symptoms varying by location—superficial at the vaginal opening or deep in the pelvis. Diagnosis typically involves physical examination and medical history, with a cotton-swab test used when no visible causes are found. Causes range from infections, hormonal changes like estrogen deficiency, to anatomical variations and psychological factors such as vaginismus. In males, causes include infections of the prostate or bladder, Peyronie's disease, and frenulum breve.

Reader's Guide

Dyspareunia is significant as a common but underdiagnosed condition affecting sexual health and quality of life. Its recognition as a pelvic floor dysfunction highlights the need for thorough evaluation of physical, psychological, and social factors. The condition's inclusion in the DSM-5 as part of genito-pelvic pain/penetration disorder underscores its clinical importance. Treatment depends on underlying causes, with many patients achieving relief when physical causes are identified and addressed. The condition's prevalence—affecting 35% of women worldwide—and its impact on relationships and mental health make it a critical area for medical attention and research.

Did You Know?

• Dyspareunia is estimated to affect 35% of women worldwide at some point in their lives.
• The cotton-swab test is used to assess for localized provoked vulvodynia when no visible causes are found.
• In males, frenulum breve was found in 50% of patients who presented with dyspareunia in one study.
• Dyspareunia is combined with vaginismus into genito-pelvic pain/penetration disorder in the DSM-5.