Materiały źródłowe

• #1 Dyspareunia (Painful Intercourse): Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/12325-dyspareunia-painful-intercourse

  Dyspareunia is genital pain during or after sexual intercourse. You may feel pain externally on your vulva or internally in your vagina, uterus or pelvis. Factors like underlying medical conditions or infections can cause painful sex. Treatment involves identifying the underlying cause of the pain. […] Pain during sex, or dyspareunia, is persistent or recurring pain just before, during or after sex. Dyspareunia is more common in women, but anyone can experience painful sex. […] Your healthcare provider may refer you to a gynecologist or a provider who specializes in sexual health. They can determine appropriate treatment based on your symptoms and the underlying condition causing you pain. […] The location of your pain can help determine what type of dyspareunia you’re experiencing. Types include: Entry pain (intraoital or superficial dyspareunia). This pain is felt at the entrance to your vagina during initial penetration. Causes could include changes in hormones, vulvar or vagina dryness, chronic irritation, infection or injury.

• #1 Assessment of dyspareunia – Differential diagnosis of symptoms | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/661

  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. […] Dyspareunia can be categorised as primary or secondary; as well as superficial or deep. […] Primary dyspareunia is characterised 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 localised 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-TR. […] The DSM-5-TR criteria specify that symptoms must have been present for approximately 6 months, be causing the patient clinically significant distress, and not be better explained by a non-sexual mental disorder or a consequence of relationship distress or other significant stressors.

• #1 Painful intercourse (dyspareunia) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/painful-intercourse/diagnosis-treatment/drc-20375973

  A medical evaluation for dyspareunia usually consists of: […] A thorough medical history. Your healthcare professional might ask when your pain began, where it hurts, how it feels and if it happens with every sexual partner and every sexual position. […] A pelvic exam. During a pelvic exam, your healthcare professional can check for symptoms of skin irritation, infection or anatomical problems. […] Other tests. If your healthcare professional suspects certain causes of painful intercourse, you might have a pelvic ultrasound. […] Treatment options vary depending on the cause of the pain. […] Your healthcare professional might ask you questions, including: How long have you had painful intercourse? […] Do you have vaginal irritation, itching or burning? […] Have you ever been diagnosed with a gynecological condition or had gynecological surgery?

• #1 Dyspareunia: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/dyspareunia

  Is it recent or has there always been dyspareunia? […] Has the dyspareunia followed childbirth? […] Where is the pain felt (superficial, deep or both)? […] When is the pain felt (before, during or after intercourse or a combination of these)? […] If pain continues after intercourse, how long does it last? […] Treatment should be directed at the underlying cause, where possible. […] A multidisciplinary approach, which includes psychosexual medicine, physiotherapy, CBT, clinical psychology and pain management teams, may be required. […] Vaginal infection may need treatment. […] Hormonal manipulation may benefit endometriosis. […] The doctor must take a positive and sympathetic approach to get the best results, as there is often a combination of physical and psychological problems.

• #1 Evaluation and Differential Diagnosis of Dyspareunia | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/0415/p1535.html/1000

  The physician distinguishes between primary and secondary dyspareunia based on whether the woman has ever had a history of successful sexual experiences. […] The pelvic examination may be deferred during the first office visit, depending on the intensity of the patient’s discomfort. […] The diagnosis remains one of exclusion because underlying conditions such as diabetes or regional enteritis may produce similar symptoms. […] The patient typically has a history of multiple treatments with little or no relief. […] The condition is now better recognized, and treatment options are available. […] Entry dyspareunia may result from a variety of conditions affecting the labia or vestibule. […] The pain associated with deep thrusting is often described as something being bumped into. […] Dyspareunia may be part of the initial presentation, which then proceeds to a persistent chronic pain.

• #1 Dyspareunia (Painful Intercourse): Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/12325-dyspareunia-painful-intercourse

  Dyspareunia doesn’t necessarily cause bleeding. Any bleeding that occurs during sexual intercourse is likely due to an underlying medical issue, which may or may not be related to the pain. […] In many cases, you can experience pain during sex if you don’t have enough vaginal lubrication. But you can also have painful intercourse because of an infection, trauma, injury or medical condition. […] Your healthcare provider can diagnose the underlying cause of pain during sex with a thorough health history and physical examination. The physical exam could include checking your pelvis, abdomen, vagina or uterus. […] To locate the source of the pain and diagnose any medical conditions, healthcare providers may perform the following: Pelvic exam: Your healthcare provider may also collect samples of vaginal fluid and pee to test for signs of infection.

• #1 Evaluation and Differential Diagnosis of Dyspareunia | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/0415/p1535.html

  Dyspareunia is genital pain associated with sexual intercourse. […] Identification of the initiating and promulgating factors is essential to reaching a successful diagnosis. […] The differential diagnoses include vaginismus, inadequate lubrication, atrophy and vulvodynia (vulvar vestibulitis). […] Urethral disorders, cystitis and interstitial cystitis may also cause painful intercourse. […] The location of the pain may be described as entry or deep. […] The physical examination may reproduce the pain, such as localized pain with vulvar vestibulitis, when the vagina is touched with a cotton swab. […] Dyspareunia is genital pain experienced just before, during or after sexual intercourse. […] The current thinking about pain initiation and promulgation suggests an initial instigating factor that is then perpetuated by confounding factors.

• #1 Dyspareunia – Wikipedia

  https://en.wikipedia.org/wiki/Dyspareunia

  Dyspareunia is painful sexual intercourse due to somatic or psychological causes. Medically, dyspareunia is a pelvic floor dysfunction and is frequently underdiagnosed. Diagnosis is typically by physical examination and medical history. Understanding the duration, location, and nature of the pain is important in identifying the causes of the pain. The differential diagnosis for dyspareunia is long because of its complicated and multifactorial nature. Dyspareunia is a condition that has many causes and is not a diagnosis of itself. It is combined with vaginismus into genito-pelvic pain/penetration disorder in the DSM-5. To meet criteria for this disorder, a patient must experience the symptoms for at least six months and experience „significant distress”.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Dyspareunia-Diagnosis.aspx

  Also, drug usage history should be taken, as a myriad of prescribed medications may have serious sexual side-effects. […] Physical examination entails a mandatory visual inspection of both external and internal genital structures to determine potential etiology of pain. […] The internal examination procedure should generally be performed by using a single finger in order to maximize the comfort of the affected individual. […] As dyspareunia may include both sensorial and affective aspects, there is a need for meticulous psychological evaluation. […] Specific sexuality questionnaires that are an indispensable part of self-administered measures play a pivotal role in both the diagnosis and treatment of dyspareunia, primarily by providing specific indicators used to evaluate the treatment outcomes.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Dyspareunia-Diagnosis.aspx

  Dyspareunia is a commonly neglected condition that manifests with persistent or recurrent urogenital pain just before, during or following sexual intercourse, mostly due to physical or psychological causes. […] As both organic and psychosexual components may be responsible for dyspareunia, there is a need for a thorough patient assessment including medical history, physical examination and psychological evaluation. Such multidisciplinary approach is warranted prior to any treatment interventions. […] When evaluating a patient with dyspareunia, thorough medical, surgical, reproductive, psychiatric, sexual and social information should be sought. […] Since pain is considered subjective, it is most often measured by using patients self-reporting. […] Moreover, any assessment should encompass a precise description of the location, quality, intensity and duration of the pain, as well as the degree of interference with individuals sexuality.

• #1 Vaginismus: Dyspareunia, Causes, Symptoms, Treatment

  https://my.clevelandclinic.org/health/diseases/15723-vaginismus

  Vaginismus can make intercourse painful (dyspareunia). […] Painful intercourse. […] You should see a doctor if you have painful sex or pain while inserting a tampon. These feelings arent normal. […] Vaginismus can affect your sex life and relationships with your partner. […] If you experience muscle spasms or pain that makes intercourse uncomfortable or impossible, dont be embarrassed to talk to your healthcare provider. You dont have to keep suffering. Many problems, including vaginismus, can cause painful intercourse. Almost all of these problems are treatable.

• #1 Dyspareunia – Is it a Diagnosis or a Description? – The ObG Project

  https://www.obgproject.com/2016/10/16/dyspareunia-diagnosis-description/

  Dyspareunia is a descriptive diagnosis for pain during or immediately following sexual intercourse. Treatment cannot be prescribed based on the descriptive diagnosis of dyspareunia. A specific diagnosis for the pain causing the dyspareunia should be identified and only then can appropriate treatment be determined. […] The generalized diagnosis of dyspareunia is made when a woman complains of pain during or immediately following intercourse. Diagnosis often describes any recurrent pain, whether experienced upon initial penetration, deep thrusting or even following intercourse. […] Diagnosing dyspareunia without establishing an underlying cause will not allow for development of the best treatment plan. The particular pain condition causing dyspareunia should be determined.

• #1 Dyspareunia (Painful Intercourse): Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/12325-dyspareunia-painful-intercourse

  There are many approaches your healthcare provider can use to treat your symptoms, but it depends on the cause. For example, if pelvic floor dysfunction is causing the pain, physical therapy may be the first treatment your provider suggests. […] Some treatments for sexual pain require prescription medication. If vaginal dryness due to low estrogen is the cause of your painful sex, topical estrogens can be applied to your vagina. […] Painful sexual intercourse can be physically and emotionally difficult. Some questions you may ask your healthcare provider are: What’s causing my pain? What treatments are available? Is there anything I can do to decrease my pain? How long will it take to feel better? […] Dyspareunia isn’t just part of life or a part of getting older. If having sex hurts you, contact your healthcare provider. It might be an uncomfortable topic, but knowing the underlying cause of your pain is important. Your provider can recommend treatment so you can enjoy a fulfilling sex life again.

• #2 Evaluation and Differential Diagnosis of Dyspareunia | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/0415/p1535.html

  Dyspareunia is genital pain associated with sexual intercourse. […] Identification of the initiating and promulgating factors is essential to reaching a successful diagnosis. […] The differential diagnoses include vaginismus, inadequate lubrication, atrophy and vulvodynia (vulvar vestibulitis). […] Urethral disorders, cystitis and interstitial cystitis may also cause painful intercourse. […] The location of the pain may be described as entry or deep. […] The physical examination may reproduce the pain, such as localized pain with vulvar vestibulitis, when the vagina is touched with a cotton swab. […] Dyspareunia is genital pain experienced just before, during or after sexual intercourse. […] The current thinking about pain initiation and promulgation suggests an initial instigating factor that is then perpetuated by confounding factors.

• #2 11 Common Causes of Painful Sex

  https://www.theoriginway.com/blog/what-no-one-tells-you-about-painful-sex-dyspareunia

  The classification of primary or secondary dyspareunia describes when your symptoms started. Your dyspareunia may be described as primary if you had pain during your first experience of intercourse, and that pain stuck around. Dyspareunia is described as secondary if you had a period of comfortable, pain-free sex before your pain developed. […] Superficial dyspareunia describes pain in the vulva or vaginal entrance (the introitus). Deep dyspareunia describes pain in the deeper vagina or lower abdominal/deep pelvic areas. […] There isn’t one common cause of dyspareunia and there may even be a number of factors that are contributing. […] With endometriosis, dyspareunia is often felt deep in the pelvis, and pain can intensify as the endometriosis progresses. […] When infection is ruled out, yet bladder symptoms and pelvic pain persist, another diagnosis that may be causing dyspareunia is Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS).

• #2 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Dyspareunia-Diagnosis.aspx

  Dyspareunia is a commonly neglected condition that manifests with persistent or recurrent urogenital pain just before, during or following sexual intercourse, mostly due to physical or psychological causes. […] As both organic and psychosexual components may be responsible for dyspareunia, there is a need for a thorough patient assessment including medical history, physical examination and psychological evaluation. Such multidisciplinary approach is warranted prior to any treatment interventions. […] When evaluating a patient with dyspareunia, thorough medical, surgical, reproductive, psychiatric, sexual and social information should be sought. […] Since pain is considered subjective, it is most often measured by using patients self-reporting. […] Moreover, any assessment should encompass a precise description of the location, quality, intensity and duration of the pain, as well as the degree of interference with individuals sexuality.

• #2 Sexual health: When being intimate hurts – Mayo Clinic Health System

  https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/womens-sexual-health-when-being-intimate-hurts

  If you experience pain during intercourse, you are not alone. An estimated 40% of women experience painful intercourse at some point in their lives. Dyspareunia is the medical term for pain that occurs immediately before, during or after intercourse but not during other activities. It is important to discuss the pain you are experiencing with your health care provider, even if you don’t experience pain every time you have intercourse. There is no minimum amount of time that you should experience discomfort before discussing it. […] A trusted health care provider can help diagnose and treat the underlying issue and prevent symptoms from worsening or progressing into a more complex problem like decreased libido, anxiety or fear of sexual activity. […] Your health care provider can provide an accurate diagnosis and appropriate treatment plan to provide relief from your symptoms.

• #2 Dyspareunia (Painful Intercourse): Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/12325-dyspareunia-painful-intercourse

  Dyspareunia doesn’t necessarily cause bleeding. Any bleeding that occurs during sexual intercourse is likely due to an underlying medical issue, which may or may not be related to the pain. […] In many cases, you can experience pain during sex if you don’t have enough vaginal lubrication. But you can also have painful intercourse because of an infection, trauma, injury or medical condition. […] Your healthcare provider can diagnose the underlying cause of pain during sex with a thorough health history and physical examination. The physical exam could include checking your pelvis, abdomen, vagina or uterus. […] To locate the source of the pain and diagnose any medical conditions, healthcare providers may perform the following: Pelvic exam: Your healthcare provider may also collect samples of vaginal fluid and pee to test for signs of infection.

• #2 Dyspareunia (Painful Intercourse): Causes, Treatments, and More

  https://www.healthline.com/health/dyspareunia

  Dyspareunia is the term for recurring pain in the genital area or within the pelvis during sexual intercourse. The pain can be sharp or intense. It can occur before, during, or after sexual intercourse. […] Dyspareunia is more common in women than men. It has many possible causes, but it can be treated. […] Several tests help doctors identify and diagnose dyspareunia. Your doctor will start by creating a complete medical and sexual history. […] A pelvic examination is also common in diagnosis. During this procedure, your doctor will look at the external and internal pelvic area for signs of: dryness, inflammation or infection, anatomical problems, genital warts, scarring, abnormal masses, endometriosis, tenderness. […] The initial examinations may lead your doctor to request other tests, such as: pelvic ultrasound, culture test to check for bacteria or yeast infection, urine test, allergy test, counseling to determine the presence of emotional causes.

• #2 Evaluation and Differential Diagnosis of Dyspareunia | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/0415/p1535.html/1000

  Dyspareunia is genital pain associated with sexual intercourse. […] Identification of the initiating and promulgating factors is essential to reaching a successful diagnosis. […] The differential diagnoses include vaginismus, inadequate lubrication, atrophy and vulvodynia (vulvar vestibulitis). […] The location of the pain may be described as entry or deep. […] The physical examination may reproduce the pain, such as localized pain with vulvar vestibulitis, when the vagina is touched with a cotton swab. […] Dyspareunia is genital pain experienced just before, during or after sexual intercourse. […] The current thinking about pain initiation and promulgation suggests an initial instigating factor that is then perpetuated by confounding factors. […] Patients with dyspareunia may complain of a well-defined and localized pain, or express a general disinterest in and dissatisfaction with intercourse that stems from the associated discomfort.

• #2 Genito-Pelvic Pain/Penetration Disorder – Women’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/women-s-health-issues/sexual-function-and-dysfunction-in-women/genito-pelvic-pain-penetration-disorder

  Doctors diagnose genito-pelvic pain/penetration disorder based on the woman’s description of the problem, including when and where the pain is felt, and on the results of a pelvic examination. […] Doctors diagnose genito-pelvic pain/penetration disorder based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association. These criteria require the presence of at least one of the following: Significant pain during intercourse or penetration attempts. […] Significant fear or anxiety about pain in anticipation of, during, or because of vaginal penetration. […] Significant tensing or tightening of the pelvic muscles during attempts to penetrate the vagina.

• #2 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Dyspareunia-Diagnosis.aspx

  Also, drug usage history should be taken, as a myriad of prescribed medications may have serious sexual side-effects. […] Physical examination entails a mandatory visual inspection of both external and internal genital structures to determine potential etiology of pain. […] The internal examination procedure should generally be performed by using a single finger in order to maximize the comfort of the affected individual. […] As dyspareunia may include both sensorial and affective aspects, there is a need for meticulous psychological evaluation. […] Specific sexuality questionnaires that are an indispensable part of self-administered measures play a pivotal role in both the diagnosis and treatment of dyspareunia, primarily by providing specific indicators used to evaluate the treatment outcomes.

• #2 Dyspareunia: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/dyspareunia

  Is it recent or has there always been dyspareunia? […] Has the dyspareunia followed childbirth? […] Where is the pain felt (superficial, deep or both)? […] When is the pain felt (before, during or after intercourse or a combination of these)? […] If pain continues after intercourse, how long does it last? […] Treatment should be directed at the underlying cause, where possible. […] A multidisciplinary approach, which includes psychosexual medicine, physiotherapy, CBT, clinical psychology and pain management teams, may be required. […] Vaginal infection may need treatment. […] Hormonal manipulation may benefit endometriosis. […] The doctor must take a positive and sympathetic approach to get the best results, as there is often a combination of physical and psychological problems.

• #2 Painful Intercourse (Dyspareunia) – University of Mississippi Medical Center

  https://umc.edu/Healthcare/Womens%20Health/Womens-Pelvic-Health-and-Reconstructive-Surgery/painful-intercourse-dyspareunia.html

  Dyspareunia or painful intercourse is defined as the complaint of persistent or recurrent pain or discomfort associated with attempted or complete vaginal penetration. […] There are many potential causes of painful intercourse, so diagnosis begins by considering when symptoms began and the location of the pain. […] A physical examination is also very helpful in determining the cause of painful intercourse. […] When all of the available information has been gathered, a diagnosis more specific than painful intercourse can almost always be made.

• #2 Evaluation and Differential Diagnosis of Dyspareunia | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/0415/p1535.html

  Complaints of pain with sexual intercourse were also associated with low physical and emotional satisfaction, as well as decreased general happiness. […] The results of one study revealed that marital adjustment was inversely associated with dyspareunic pain rating and that only anxiety and marital adjustment were significant independent predictors of dyspareunic pain rating. […] The optimal approach incorporates social learning and operant conditioning models with pain, psychologic and physical conditions. […] The physician distinguishes between primary and secondary dyspareunia based on whether the woman has ever had a history of successful sexual experiences. […] The diagnosis remains one of exclusion because underlying conditions such as diabetes or regional enteritis may produce similar symptoms.

• #3 Dyspareunia (Painful Intercourse): Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/12325-dyspareunia-painful-intercourse

  Pain during intercourse can also be described as primary, secondary, complete or situational: Primary pain is pain you’ve had since becoming sexually active. Secondary pain develops after experiencing pain-free sex. Complete pain means you feel pain every time you have sex. Situational pain is when the pain only happens at certain times. […] Pain during sex is more common in females, affecting 3 out of 4 at some point in their lives. […] Anyone of any age can experience painful sex. But it’s more likely to affect women who are past menopause (the average age of menopause is 51). This is mainly due to a decrease in estrogen, a hormone that helps with lubrication and other aspects of your vaginal health. […] If you have pain during sex, you may feel: Sharp pain during penetration or at entry (or even when using a tampon). Deep pain during thrusting. Throbbing or aching after intercourse. Pelvic cramping. Muscle tightness or spasms. Bladder pain.

• #3 Painful Sexual Intercourse (Dyspareunia) – Prof. Dr. Basak Baksu

  https://basakbaksu.com.tr/en/agrili-cinsel-iliski-disparoni-2/

  Structural anatomical disorder, dryness, discharge, mass in the vagina […] Abnormal appearance of the cervix […] larger than normal uterus […] Restriction or pain in uterine movements […] Tenderness, pain, palpable mass in the lower abdomen […] Your doctor will decide which tests are necessary for you based on your age, other accompanying complaints, history and examination findings. The following are requested in patients presenting with dyspareunia: […] Urine culture Used in the diagnosis of urinary tract infection. […] Vaginal and cervical culture in women Desired to detect infective agents originating from the vagina and cervix. […] Allergy testing Required if contact dermatitis is present. […] Magnetic resonance Provides illuminating information on all lower abdominal masses.

• #3 Painful intercourse (dyspareunia) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/painful-intercourse/symptoms-causes/syc-20375967

  These involuntary spasms of the muscles of the vaginal wall can make penetration painful. […] Not having a fully formed vagina, called vaginal agenesis, or having a membrane that blocks the vaginal opening, called imperforate hymen, could cause painful intercourse. […] Deep pain usually occurs with deep penetration. It might be worse in certain positions. […] The list includes endometriosis, pelvic inflammatory disease, uterine prolapse, retroverted uterus, uterine fibroids, cystitis, irritable bowel syndrome, pelvic floor conditions, adenomyosis, hemorrhoids and ovarian cysts. […] Scarring from pelvic surgery, including hysterectomy, can cause painful intercourse. Medical treatments for cancer, such as radiation and chemotherapy, can cause changes that make sex painful. […] Emotions are deeply intertwined with sexual activity, so they might play a role in sexual pain.

• #3 Assessment of dyspareunia – Differential diagnosis of symptoms | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/661

  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. […] Dyspareunia can be categorised as primary or secondary; as well as superficial or deep. […] Primary dyspareunia is characterised 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 localised 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-TR. […] The DSM-5-TR criteria specify that symptoms must have been present for approximately 6 months, be causing the patient clinically significant distress, and not be better explained by a non-sexual mental disorder or a consequence of relationship distress or other significant stressors.

• #4 Dyspareunia (Painful Intercourse) | Baylor Scott & White Health

  https://www.bswhealth.com/conditions/dyspareunia

  Your provider may perform a pelvic exam or a visual examination of the genital area. […] Based on the results of your medical history and pelvic exam, your OBGYN may recommend an imaging test to look inside your pelvic organs and try to find the cause of your pain. […] A medical evaluation for dyspareunia usually consists of: Medical history, Pelvic exam, Imaging, Laparoscopy. […] You have many options for treating sexual pain. The right treatment for you will depend on the cause of your discomfort. […] When sexual tension, a lack of arousal or trauma contribute to painful intercourse, you may benefit from counseling to overcome those causes. […] Your provider may recommend surgery to correct pelvic organ abnormalities, treat endometriosis, remove uterine fibroids and address other underlying causes of your pain.

• #4 Painful intercourse (dyspareunia) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/painful-intercourse/symptoms-causes/syc-20375967

  Anxiety, depression, concerns about physical appearance, fear of intimacy or relationship problems can contribute to a low level of arousal and resulting discomfort or pain. […] Your pelvic floor muscles tend to tighten in response to stress in your life. This can contribute to pain during intercourse. […] It can be hard to tell whether emotional factors are associated with dyspareunia. Initial pain can lead to fear of recurring pain, making it difficult to relax, which can lead to more pain. You might start avoiding sex if you associate it with the pain. […] Many factors can raise the risk of painful intercourse. They include illnesses, surgeries and other medical treatments, and mental health issues.

• #4 Sexual Pain Disorders

  https://labs.la.utexas.edu/mestonlab/sexual-pain-disorders-3/

  The DSM-IV-TR included two sexual pain disorders, dyspareunia and vaginismus. The DSM-5 subworkgroup on sexual dysfunction combined these two disorders into genito-pelvic pain/penetration disorder. […] In the DSM-5, genito-pelvic pain/penetration disorder (GPPPD) is defined as persistent or recurrent difficulties with one or more of the following: (1) vaginal penetration during intercourse; (2) vulvovaginal or pelvic pain during vaginal intercourse or attempts at penetration; (3) fear or anxiety about vulvovaginal or pelvic pain in anticipation of, during, or as a result of vaginal penetration; and (4) tightening or tensing of the pelvic floor muscles during attempted vaginal penetration. […] GPPPD was created, in part, in response to arguments made by Binik (2010a), who questioned the logic of maintaining two separate sexual pain diagnoses for women, given the high rates of comorbidity between painful sex and difficulties with penetration.

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