Concept

Dyspareunia

Summary
Dyspareunia (dIsp@r'uni@ ) is painful sexual intercourse due to medical or psychological causes. The term dyspareunia covers both female dyspareunia and male dyspareunia, but many discussions that use the term without further specification concern the female type, which is more common than the male type. In females, the pain can primarily be on the external surface of the genitalia, or deeper in the pelvis upon deep pressure against the cervix. Medically, dyspareunia is a pelvic floor dysfunction and is frequently underdiagnosed. It can affect a small portion of the vulva or vagina or be felt all over the surface. Understanding the duration, location, and nature of the pain is important in identifying the causes of the pain. Numerous physical, psychological, and social or relationship causes can contribute to pain during sexual encounters. Commonly, multiple underlying causes contribute to the pain. The pain can be acquired or congenital. Symptoms of dyspareunia may also occur after menopause. Diagnosis is typically by physical examination and medical history. Underlying causes determine treatment. Many patients experience relief when physical causes are identified and treated. In 2020, dyspareunia has been estimated to globally affect 35% of women at some point in their lives. Those who experience pelvic pain upon attempted vaginal intercourse describe their pain in many ways. This reflects how many different and overlapping causes there are for dyspareunia. The location, nature, and time course of the pain help to understand potential causes and treatments. Some describe superficial pain at the opening of the vagina or surface of the genitalia when penetration is initiated. Others feel deeper pain in the vault of the vagina or deep within the pelvis upon deeper penetration. Some feel pain in more than one of these places. Determining whether the pain is more superficial or deep is important in understanding what may be causing the pain.
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