Table of Contents
dyspareunia
introduction
superficial dyspareunia
deep dyspareunia
dyspareunia
see also:
gynaecology
introduction
dyspareunia refers to pain on sexual intercourse in the female.
it is classically divided into:
superficial - pain on the external genitalia or vaginismus due to reflex spasm of levator ani and perineal muscles which may be psychogenic.
deep - deeper pelvic pain which tends to be related to pelvic pathology or
chronic pelvic pain in women
superficial dyspareunia
aetiology
vaginitis
- atrophic or infectious
lack of lubrication
irritating vaginal medications
psychogenic vaginismus including secondary to anticipation of deep dyspareunia.
sympathomimetic drugs
including amphetamine & cocaine
episiotomy or surgical sequelae - may only be a tiny scar
cystitis or
urinary tract infections (UTIs) / cystitis
urethral syndrome or other urinary tract disorders
introital, vaginal or cervical scarring
levator ani myalgia
vulvar vestibulitis
extensive prolapse
hypersensitivity reactions to latex (eg. condoms)
other painful local lesions - eg. Bartholin cyst/abscess.
deep dyspareunia
aetiology
pelvic inflammatory disease (PID)
endometriosis
pelvic masses including
ovarian cysts and other cysts in the adnexae
and
ovarian tumours
chronic pelvic pain in women
retroverted uterus
broad ligament varocosities
broad ligament tear syndrome
GIT conditions such as inflammatory bowel disease