Bolesne współżycie (dyspareunia)

Bolesne współżycie (dyspareunia)
Epidemiologia

Dyspareunia definiowana jest jako nawracający lub utrzymujący się ból w okolicy narządów płciowych przed, w trakcie lub po stosunku seksualnym, powodujący istotne cierpienie i konflikty interpersonalne. Częstość występowania u kobiet waha się globalnie od 8% do 35%, z danymi wskazującymi na nawet 75% doświadczających bolesnego współżycia w pewnym momencie życia. Czynniki ryzyka obejmują młodszy wiek, niższy poziom wykształcenia, objawy układu moczowego, słaby stan zdrowia, stres oraz spadek dochodów. Szczególnie narażone są kobiety po menopauzie (ok. 50% z atrofii pochwy) oraz w okresie poporodowym, gdzie dyspareunia dotyka 22-45% kobiet w pierwszych miesiącach po porodzie. Interesujące jest, że cesarskie cięcie wiąże się ze zwiększonym ryzykiem dyspareunii (OR 1,74; 95% CI 1,46-2,08) nawet 11 lat po porodzie. U mężczyzn problem jest rzadszy (3-5% w krajach zachodnich), a u osób transpłciowych obserwuje się wyższą częstość występowania, co podkreśla potrzebę specjalistycznej opieki medycznej.

Epidemiologia bolesnego współżycia (dyspareunia) – przegląd ogólny

Dyspareunia (bolesne współżycie płciowe) to nawracający lub utrzymujący się ból w okolicy narządów płciowych występujący przed, w trakcie lub po stosunku seksualnym, który powoduje znaczne cierpienie lub konflikty interpersonalne. Jest to powszechny problem zdrowotny, dotykający znaczącą część populacji, szczególnie kobiet.¹²

Częstość występowania na świecie

Częstość występowania dyspareunii znacznie różni się w zależności od przyjętej definicji oraz badanej populacji. Światowa Organizacja Zdrowia raportuje globalną częstość występowania dyspareunii w zakresie od 8% do 21,1% (dane z 2006 roku), ze znacznymi różnicami między krajami.¹²

Przeglądy systematyczne wskazują na występowanie dyspareunii u 8-35% kobiet na świecie.¹ W badaniach globalnych szacuje się, że problem ten może dotykać nawet 35% kobiet w pewnym momencie ich życia.¹

Częstość występowania w Stanach Zjednoczonych

W Stanach Zjednoczonych częstość występowania dyspareunii szacuje się na poziomie 10-20% kobiet, przy czym przyczyny różnią się w zależności od grupy wiekowej.¹²³ Niektóre badania wskazują jednak na znacznie wyższy odsetek – od 7% do nawet 46% kobiet aktywnych seksualnie.¹²

Amerykańskie Kolegium Położników i Ginekologów (ACOG) podaje, że aż 75% kobiet doświadcza bolesnego stosunku w pewnym momencie życia.¹²

Częstość występowania w Wielkiej Brytanii

Badanie przeprowadzone w Wielkiej Brytanii wykazało, że bolesne stosunki seksualne zgłaszało 7,5% aktywnych seksualnie kobiet.¹² Wśród nich około jedna czwarta doświadczała objawów bardzo często lub zawsze, przez co najmniej 6 miesięcy, co powodowało znaczny dyskomfort psychiczny.¹

Częstość występowania w ciągu życia

Szacuje się, że 10-28% populacji na świecie doświadczy bolesnego stosunku seksualnego przynajmniej raz w życiu.¹² Niektóre badania sugerują, że przy szerokiej definicji dyspareunii, czyli jako epizodycznego bólu podczas stosunku, odsetek dotkniętych kobiet może sięgać nawet 60%.¹²

Co ważne, aż 3 na 4 kobiety mogą doświadczyć bolesnego współżycia w pewnym momencie życia.¹

Czynniki ryzyka dyspareunii

Zidentyfikowano liczne czynniki zwiększające ryzyko wystąpienia bolesnego współżycia:¹

Młodszy wiek – dyspareunia jest częstsza u kobiet w młodszym wieku¹²
Wykształcenie poniżej poziomu studiów wyższych¹
Objawy ze strony układu moczowego¹
Ogólny stan zdrowia określany jako słaby lub dostateczny¹
Problemy emocjonalne lub stres¹
Spadek dochodów gospodarstwa domowego o ponad 20%¹

Częstość występowania w specyficznych populacjach

Kobiety po menopauzie

Dyspareunia jest jednym z najczęstszych problemów kobiet po menopauzie.¹ Atrofia pochwy, dotykająca około 50% kobiet po menopauzie z powodu obniżonego poziomu estrogenu, często prowadzi do bolesnego współżycia.¹

Przegląd Cochrane obejmujący 19 badań z udziałem ponad 4000 kobiet wykazał, że preparaty estrogenowe (kremy, pierścienie lub tabletki) były związane ze statystycznie istotnym zmniejszeniem objawów atrofii pochwy w porównaniu z placebo lub żelami niehormonalnymi.¹

Kobiety w okresie poporodowym

Okres poporodowy, szczególnie u kobiet karmiących piersią, charakteryzuje się zmniejszeniem krążącego estrogenu, co może prowadzić do suchości pochwy i dyspareunii.¹ Po pierwszych porodach drogami natury, odpowiednio 41% i 22% kobiet doświadcza dyspareunii w trzecim i szóstym miesiącu po porodzie.¹ Z kolei dyspareunia poporodowa obserwowana była u 45% kobiet w badaniu z USA.¹

Kobiety po cesarskim cięciu

Wbrew powszechnym przekonaniom, cesarskie cięcie nie chroni przed dysfunkcjami seksualnymi. Badanie z Uniwersytetu w Bristolu wykazało, że cesarskie cięcie było związane z 74% zwiększonym ryzykiem dyspareunii, a nie było to koniecznie związane z blizną brzuszną.¹

Kobiety, które rodziły przez cesarskie cięcie, częściej niż te, które rodziły drogami natury, zgłaszały ból związany z seksem 11 lat po porodzie. Dotyczyło to szczególnie zwiększonej częstości bólu w pochwie podczas stosunku, z ilorazem szans 1,74 (95% CI 1,46-2,08) w modelu skorygowanym. Wynik był spójny zarówno dla nagłego, jak i planowego cesarskiego cięcia.¹

Mężczyźni transpłciowi

Badanie opublikowane w 2022 roku w LGBT Health wykazało, że mężczyźni transpłciowi doświadczali wyższej częstości występowania dyspareunii w porównaniu z populacją ogólną.¹ Wiele osób transpłciowych doświadcza trudności w znalezieniu lekarzy posiadających wiedzę na temat zdrowia osób transpłciowych, a negatywne doświadczenia w opiece zdrowotnej powodują ogólny brak zaufania do systemu medycznego.¹

Dyspareunia u mężczyzn

Chociaż dyspareunia dotyka zarówno kobiety, jak i mężczyzn, jest znacznie rzadsza w populacji męskiej.¹² Szacuje się, że problem ten dotyczy 3-5% mężczyzn w krajach zachodnich oraz 10-12% mężczyzn na Bliskim Wschodzie i w Azji Południowo-Wschodniej.¹

U mężczyzn dyspareunia najczęściej jest spowodowana problemami medycznymi, a objawy mogą się różnić od izolowanego bólu moszny lub prącia do bardziej uogólnionego bólu dolnej części miednicy.¹²

Nadzór i zgłaszanie dyspareunii

Mimo znacznej częstości występowania, dyspareunia jest często niedostatecznie zgłaszana i diagnozowana:¹

Kobiety z objawami na tyle poważnymi, by wymagały interwencji medycznej, stanowią jedynie niewielki podzbiór wszystkich przypadków, ponieważ większość pacjentek nie szuka pomocy medycznej¹²
Badania wykazały, że tylko 10% kobiet cierpiących na dyspareunię rozpoznaje ją jako dysfunkcję seksualną¹
Średni czas oczekiwania na diagnozę wynosi około 5 lat¹
Trudno oszacować dokładną częstość występowania dyspareunii, ponieważ prawdopodobnie wiele kobiet jej nie zgłasza¹

Dokładne szacunki częstości występowania i zapadalności są istotne dla zrozumienia obciążenia, jakie dyspareunia stanowi dla społeczeństwa, oraz dla identyfikacji czynników ryzyka w celu podejmowania działań profilaktycznych.¹

Zróżnicowanie demograficzne

Rozkład wiekowy

Dyspareunia może wystąpić w każdym wieku, ale jest częstsza u kobiet młodszych oraz u kobiet po menopauzie (średni wiek menopauzy to 51 lat).¹²

Chociaż dane kliniczne sugerują, że dyspareunia może rozpocząć się w okresie dojrzewania, jak dotąd nie przeprowadzono szeroko zakrojonych badań epidemiologicznych w tej populacji.¹

Różnice rasowe/etniczne

Nie stwierdzono predylekcji rasowej w przypadku dyspareunii, chociaż przynależność do rasy afroamerykańskiej została zidentyfikowana jako czynnik ryzyka bólu miednicy.¹

Częstość występowania dyspareunii w Brazylii waha się od 1,2% do 56,1%, co różni się od wskaźnika częstości występowania w Portoryko wynoszącego 17% do 21%.¹

Wpływ i znaczenie dyspareunii

Dyspareunia ma znaczący wpływ na jakość życia kobiet i ich partnerów:¹

Jest związana ze zwiększonym ryzykiem dysfunkcji seksualnych i problemów w relacjach¹
Może wpływać na pewność siebie, samoocenę i obraz własnej osoby¹
Oprócz bólu fizycznego, pary mogą doświadczać utraty intymności lub napięcia w związkach¹
Jest powiązana z gorszym zdrowiem seksualnym, fizycznym, relacyjnym i psychicznym¹

Oczekiwanie na bolesny stosunek może prowadzić do unikania współżycia lub zmiany rodzaju stosowanej antykoncepcji, co może być mniej lub bardziej wygodne dla kobiety.¹

Podejście diagnostyczne i lecznicze

Dyspareunia jest klasyfikowana na podstawie czterech głównych czynników: początku, częstości, lokalizacji i przyczyny.¹ Skuteczne leczenie wymaga dokładnej diagnozy i holistycznego podejścia.

Ocena medyczna dyspareunii zwykle obejmuje:¹²

Dokładny wywiad medyczny, w tym pytania o początek bólu, miejsce, charakter i okoliczności jego występowania
Historię seksualną, chirurgiczną i historię porodów

Opcje leczenia różnią się w zależności od przyczyny bólu:¹²

Leczenie infekcji lub schorzenia podstawowego może rozwiązać problem
Zmiana leków, które mogą powodować problemy z lubrykacją
Stosowanie ospemifenu (Osphena) – leku zatwierdzonego przez FDA do leczenia umiarkowanej do ciężkiej dyspareunii u kobiet z problemami z lubrykacją pochwy
Terapia poznawczo-behawioralna, poradnictwo i fizjoterapia¹
Podejście multidyscyplinarne, obejmujące medycynę psychoseksualną, fizjoterapię, zespoły zajmujące się leczeniem bólu¹

Dyspareunia była historycznie klasyfikowana jako zaburzenie seksualne, ale po wielu badaniach jest obecnie leczona z wykorzystaniem zintegrowanego podejścia opartego na modelu bólu.¹

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Materiały źródłowe

#1 Dyspareunia – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK562159/
Painful sexual intercourse is a common female health problem. In medical terminology, it is called dyspareunia. The prevalence of dyspareunia varies from 3 to 18% worldwide, and it can affect 10 to 28% of the population in a lifetime. The incidence of dyspareunia mainly depends on the definition used and, therefore, the population sampled. In the United States, the prevalence can be between 7% to 46%. Dyspareunia affects both males and females. However, it is far more common in the female population. […] Women with symptoms severe enough to require medical attention comprise a small subset as most patients do not seek medical attention making the true incidence rather challenging to determine.
#1 Dyspareunia epidemiology and demographics – wikidoc
https://www.wikidoc.org/index.php/Dyspareunia_epidemiology_and_demographics
The World Health Organization reported a global prevalence of dyspareunia ranging between 8% and 21.1% in 2006, which varied by country. […] Although clinical data suggest that dyspareunia can begin during adolescence, no large-scale epidemiological study has been conducted yet with this population. […] There is no racial predilection to dyspareunia, although African-American race was found to be a risk factor for pelvic pain. […] Dyspareunia affects women more than men. It can be seen in men rarely. […] The prevalence of dyspareunia in the United States is approximately 10% to 20%, with the underlying causes varying by age group. […] The World Health Organization reported a global prevalence of dyspareunia ranging between 8% and 21.1% in 2006, which varied by country. The prevalence of dyspareunia in Brazil is reported ranged from 1.2% to 56.1%, which differs from Puerto Ricos prevalence rate of 17% to 21%.
#1 Assessment of dyspareunia – Differential diagnosis of symptoms | BMJ Best Practice
https://bestpractice.bmj.com/topics/en-us/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. Systematic reviews report dyspareunia prevalence ranging from 8% to 35%. […] One UK survey found that painful sex was reported by 7.5% of sexually active women. […] In the US, dyspareunia is estimated to affect 10% to 20% of women.
#1 Dyspareunia – Wikipedia
https://en.wikipedia.org/wiki/Dyspareunia
Dyspareunia is painful sexual intercourse due to somatic or psychological causes. In 2020, dyspareunia has been estimated to globally affect 35% of women at some point in their lives. 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.
#1 Dyspareunia in Women | AAFP
https://www.aafp.org/pubs/afp/issues/2014/1001/p465.html
Dyspareunia is recurrent or persistent pain with sexual activity that causes marked distress or interpersonal conflict. It affects approximately 10% to 20% of U.S. women. […] The prevalence of dyspareunia is approximately 10% to 20% in U.S. women, with the leading causes varying by age group. […] Significant risk factors and predictors for dyspareunia include younger age, education level below a college degree, urinary tract symptoms, poor to fair health, emotional problems or stress, and a decrease in household income greater than 20%. […] Dyspareunia is a common presenting symptom in women with vaginal atrophy. Vaginal atrophy affects approximately 50% of postmenopausal women because of decreasing levels of estrogen. […] After first vaginal deliveries, 41% and 22% of women at three and six months, respectively, experience dyspareunia.
#1 Dyspareunia (Painful Intercourse): Causes, Treatments, and More
https://www.healthline.com/health/dyspareunia
Dyspareunia is more common in women than men. […] Around 75 percent of women have painful intercourse at some time, according to the American College of Obstetricians and Gynecologists (ACOG). […] Dyspareunia is one of the most common problems of postmenopausal women. […] Both women and men can experience dyspareunia, but the condition is more common in women.
#1 Painful sex (dyspareunia) in women: prevalence and associated factors in a British population probability survey – University of Technology Sydney
http://search.lib.uts.edu.au/discovery/fulldisplay/cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5638059/61UTS_INST:61UTS
Objective To estimate the prevalence of painful sex among women in Britain, and to explore associated sexual, relationship and health factors that should be considered in assessment. […] Painful sex was reported by 7.5% (95% CI 6.7â8.3) of sexually active women, of whom one-quarter experienced symptoms very often or always, for â¥6 months, and causing distress. […] Conclusion Painful sex is reported by a sizeable minority of women in Britain. Health professionals should be supported to undertake holistic assessment and treatment which takes account of the sexual, relationship and health context of symptoms. […] Painful sexâreported by 7.5% of women in Britainâis linked to poorer sexual, physical, relational and mental health.
#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. […] The incidence of dyspareunia depends on the definition used and the population sampled. […] The prevalence of dyspareunia in this sample was 7 percent. In a study of primary care practices, the prevalence of dyspareunia was 46 percent among sexually active women, with dyspareunia defined as pain during or after intercourse. […] As many as 60 percent of women experience dyspareunia when the term is broadly defined as episodes of pain with intercourse. […] There are few reports of clinical trials relating to dyspareunia, and much of the literature derives from expert opinion.
#1 What Are Common Causes of Dysparenia?
https://www.pharmacytimes.com/view/what-are-common-causes-of-dysparenia
As many as 3 of 4 women will have pain during intercourse, known as dyspareunia, at some point in their lives. Dyspareunia has historically been classified as a sexual disorder. After some significant research, it is now treated with an integrated pain-model approach. […] Dyspareunia can occur for myriad reasons, from psychological issues to structural abnormalities, and can cause negative emotional effects and problems in a relationship. It also can be a sign of a gynecological problem, such as endometriosis, menopause, or ovarian cysts, or it can be caused by sexual response issues, such as a lack of arousal or desire stemming from an array of circumstances. […] Pain during intercourse is usually associated with an underlying condition and should be checked by either a gynecologist or primary care provider.
#1 Dyspareunia
https://mobile.fpnotebook.com/Gyn/Sx/Dysprn.htm
Prevalence: 10-20% of women in the United States […] Age: More common on younger ages.
#1 Dyspareunia in Women | AAFP
https://www.aafp.org/pubs/afp/issues/2014/1001/p465.html
The postpartum period, especially in breastfeeding women, is marked by a decrease in circulating estrogen, which can lead to vaginal dryness and dyspareunia. […] A 2006 Cochrane review of 19 trials involving more than 4,000 women found that estrogen preparations cream, ring, or tablet were associated with a statistically significant reduction in symptoms of vaginal atrophy compared with placebo or nonhormonal gels.
#1 Azthena logo with the word Azthena
https://www.news-medical.net/health/What-is-Dyspareunia.aspx
However, a study that looked primary care practices found dyspareunia in 46% of sexually active women (with the definition including pain during or after sexual intercourse). Moreover, postpartum dyspareunia was observed in 45% of women in a study from the US. […] If dyspareunia is broadly defined as episodic pain during sexual intercourse, the percentage of affected women climbs up to 60%. However, women that have such severe symptoms that they actually seek medical attention are part of a much smaller group (which is why the condition is not always recognized).
#1 Increased Risk of Dyspareunia Following Caesarean Section
https://www.medscape.co.uk/viewarticle/increased-risk-dyspareunia-following-caesarean-section-2022a10021x3
There is no evidence to support postulated associations between mode of delivery and subsequent maternal sexual enjoyment or frequency of intercourse, according to a new study from the University of Bristol. However, Caesarean section was shown to be associated with a 74% increased risk of dyspareunia, and this was not necessarily due to abdominal scarring, the researchers said. […] There is some evidence that Caesarean section is associated with an increased risk of sexual problems such as dyspareunia, but few studies have looked at the post-birth period long term. […] However, while the majority of respondents reported no intercourse-related pain, those who delivered via Caesarean were more likely than those who gave birth vaginally to report sex-related pain at 11 years postpartum. This was specifically an elevated incidence of pain in the vagina during sex, with an odds ratio of 1.74 (95% CI 1.46 to 2.08) in the adjusted model. This finding was consistent for emergency and elective Caesarean section separately – both types were associated with increased dyspareunia compared with vaginal delivery.
#1 The Dyspareunia Diaries — The Otter
https://theotter.ca/dyspareunia-diaries/
A 2022 study published by LGBT Health found that trans men experienced a higher prevalence of dyspareunia in comparison to the general population. […] Many trans people experience challenges finding physicians who are knowledgeable about trans health, and negative experiences in health care foster distrust of the medical system generally. […] Some medical professionals are, however, invested in finding relief for people suffering from dyspareunia. […] Coens also sees a lack of awareness regarding dyspareunia among the general publicmany patients who find themselves in her office are usually there for reasons other than chronic pelvic pain. […] Pukall acknowledges the common spread of misinformation regarding sex for people with vaginas, specifically the assumption that sex is supposed to be painful. […] Research has shown that, on average, patients are waiting five years for a diagnosis. […] Dyspareunia is not always caused by trauma, and for some people, they have nothing else to compare it to when feeling discomfort during sex.
#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. 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. Pain during sex is more common in females, affecting 3 out of 4 at some point in their lives. Up to 28% of all people in the United States will experience painful sex at least once. Anyone of any age can experience painful sex. But its more likely to affect women who are past menopause (the average age of menopause is 51). Dyspareunia is a common condition that can have negative emotional and psychological effects. In addition to the physical pain, couples may experience a loss of intimacy or strain in their relationships. Pain during sex is more common in women, especially those who have reached menopause. The pain is often due to physical factors or medical conditions, but it can also be psychological or due to a mental health condition.
#1 Dyspareunia (302.76) | Abnormal Psychology
https://courses.lumenlearning.com/atd-herkimer-abnormalpsych/chapter/dyspareunia-302-76/
In a survey of 329 women in 1993 at a gynecological clinic it was found that 7.7% of women experienced painful intercourse on most or all occasions. There is very little data on the prevalence of this disorder in men. However, studies have shown that when this disorder exists in men, it is usually caused by a medical problem. […] 60% of women experience genital pain before, during, or after intercourse at some point. However, the location and frequency varies among women. […] Estimates of the prevalence of male dyspareunia are sparse but appear to affect 3% to 5% of men in Western countries and 10% to 12% of men in the Middle East and Southeast Asia.
#1 Approach to dyspareunia in men – UpToDate
https://www.uptodate.com/contents/approach-to-dyspareunia-in-men
INTRODUCTION AND DEFINITION […] The term „dyspareunia” refers to pain associated with sexual intercourse, which causes significant psychologic distress. Symptoms vary widely, from isolated scrotal or penile pain to more generalized lower pelvic pain. Sexual dysfunction may also be present. While male dyspareunia is often used to describe a heterogenous group of symptoms, a consistent, unifying factor is the presence of recurrent or persistent genital or pelvic pain with sexual activity, lasting for three months or more. The condition often leads to embarrassment and may be difficult for the patient and clinician to discuss openly. […] […] […] EPIDEMIOLOGY […] […] […] This topic will focus on the evaluation of dyspareunia in men, particularly when genital discomfort with sexual activity is the primary concern. Discomfort with sexual activity as a component of other conditions is discussed with each primary condition.
#1
https://www.nursingcenter.com/cearticle?an=00006205-202311000-00006&Journal_ID=54012&Issue_ID=6813630
Dyspareunia in women is a recurrent pain in the genital and/or pelvic area associated with sexual intercourse. Dyspareunia is associated with increased risk of sexual dysfunction and relationship distress, and it may impact an individual’s confidence, self-image, and self-esteem. […] Research conducted in the US indicates that between 7% and 58% of women suffer from dyspareunia. According to the American College of Obstetricians and Gynecologists, the prevalence is even higher, with a rate of up to 75% of women experiencing painful intercourse during their lives. […] Regardless of presentation, many women with dyspareunia are reluctant to report their symptoms to medical providers. Dyspareunia is therefore underreported despite its prevalence. Research has found that only 10% of women suffering from dyspareunia recognize it as sexual dysfunction.
#1 Dyspareunia: Causes, Symptoms, and Treatment | Doctor
https://patient.info/doctor/dyspareunia
Dyspareunia is pain during or after sexual intercourse. It can affect men but is more common in women. This article concerns female dyspareunia. […] It is difficult to estimate the incidence of dyspareunia accurately, as it is likely that many women do not report it. The prevalence of dyspareunia and vulvodynia varies by how they are defined and by geographic location. The World Health Organization reported a global prevalence of painful intercourse ranging between 8% and 21.1% in 2006, which varied by country. […] A multidisciplinary approach, which includes psychosexual medicine, physiotherapy, CBT, clinical psychology and pain management teams, may be required.
#1 Epidemiology of FSD » Sexual Medicine » BUMC
https://www.bumc.bu.edu/sexualmedicine/physicianinformation/epidemiology-of-fsd/
The epidemiology of female sexual dysfunction is not well understood for many reasons. […] Accurate estimates of prevalence and incidence are important in understanding the burden of female sexual dysfunction in the community and in identifying risk factors for prevention efforts. […] The overall prevalence of dysfunction was reported by three studies, and ranged from 19% to 42%. […] Dyspareunia was experienced by about 12% of women in two studies, and 33% in a third. […] The prevalence of dyspareunia among women with partners was 15.5%. […] Estimates of dysfunction from an older population (60 years) is provided by a probability sample of adults in Michigan. […] About 13% experienced pain with intercourse. […] The prevalence of dyspareunia was fairly consistent across studies, ranging from 7% to 13%.
#1 Dyspareunia – Painful Sex | familydoctor.org
https://familydoctor.org/condition/dyspareunia/
Treatments depend on what is causing your pain. They may include sexual lubricants (over-the-counter products), antibiotics for infections, a different type of birth control, or surgery. […] Living with dyspareunia may be physically uncomfortable. However, it may affect your sexual relationship as well. Anticipating painful sex may cause you to avoid it. It may change the type of birth control you use (which may or may not be convenient for you).
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https://www.nursingcenter.com/cearticle?an=00006205-202311000-00006&Journal_ID=54012&Issue_ID=6813630
Dyspareunia is classified based on four primary factors: onset, frequency, location, and cause. […] Various causes underlie dyspareunia. Although causes are usually physical, psychological factors may be involved in those cases in which investigation does not find a physical cause. […] The appropriate management of dyspareunia can be established after diagnosis of the cause. Management may include pharmacologic and nonpharmacologic interventions, including cognitive behavioral therapy, counseling, and physical therapy. […] Dyspareunia is a complex condition that affects the physical and mental well-being of many women from reproductive age through postmenopause.
#1 Painful intercourse (dyspareunia) – Hancock Health
https://www.hancockhealth.org/mayo-health-library/painful-intercourse-dyspareunia/
Painful intercourse can happen for reasons that range from structural problems to psychological concerns. Many people have painful intercourse at some point in their lives. The medical term for painful intercourse is dyspareunia (dis-puh-ROO-nee-uh). It is lasting or recurrent genital pain that occurs just before, during or after sex. Talk with your healthcare professional if you’re having painful intercourse. Treatments focus on the cause and can help stop or ease this common problem. […] Many factors can raise the risk of painful intercourse. They include illnesses, surgeries and other medical treatments, and mental health issues. […] 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. Your healthcare professional also might ask about your sexual history, surgical history and history of childbirth.
#1 Painful intercourse (dyspareunia) – Hancock Health
https://www.hancockhealth.org/mayo-health-library/painful-intercourse-dyspareunia/
Treatment options vary depending on the cause of the pain. […] If an infection or medical condition contributes to your pain, treating the cause might resolve your problem. Changing medicines that can cause lubrication problems also might eliminate your symptoms. […] The Food and Drug Administration approved the medicine ospemifene (Osphena) to treat moderate to severe dyspareunia in women who have problems with vaginal lubrication. Ospemifene acts like estrogen in the vaginal lining. […] Many factors can raise the risk of painful intercourse. They include illnesses, surgeries and other medical treatments, and mental health issues.
#2 Dyspareunia in Women | AAFP
https://www.aafp.org/pubs/afp/issues/2014/1001/p465.html
Dyspareunia is recurrent or persistent pain with sexual activity that causes marked distress or interpersonal conflict. It affects approximately 10% to 20% of U.S. women. […] The prevalence of dyspareunia is approximately 10% to 20% in U.S. women, with the leading causes varying by age group. […] Significant risk factors and predictors for dyspareunia include younger age, education level below a college degree, urinary tract symptoms, poor to fair health, emotional problems or stress, and a decrease in household income greater than 20%. […] Dyspareunia is a common presenting symptom in women with vaginal atrophy. Vaginal atrophy affects approximately 50% of postmenopausal women because of decreasing levels of estrogen. […] After first vaginal deliveries, 41% and 22% of women at three and six months, respectively, experience dyspareunia.
#2 Dyspareunia: Causes, Symptoms, and Treatment | Doctor
https://patient.info/doctor/dyspareunia
Dyspareunia is pain during or after sexual intercourse. It can affect men but is more common in women. This article concerns female dyspareunia. […] It is difficult to estimate the incidence of dyspareunia accurately, as it is likely that many women do not report it. The prevalence of dyspareunia and vulvodynia varies by how they are defined and by geographic location. The World Health Organization reported a global prevalence of painful intercourse ranging between 8% and 21.1% in 2006, which varied by country. […] A multidisciplinary approach, which includes psychosexual medicine, physiotherapy, CBT, clinical psychology and pain management teams, may be required.
#2 Assessment of dyspareunia – Differential diagnosis of symptoms | BMJ Best Practice
https://bestpractice.bmj.com/topics/en-us/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. Systematic reviews report dyspareunia prevalence ranging from 8% to 35%. […] One UK survey found that painful sex was reported by 7.5% of sexually active women. […] In the US, dyspareunia is estimated to affect 10% to 20% of women.
#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. […] The incidence of dyspareunia depends on the definition used and the population sampled. […] The prevalence of dyspareunia in this sample was 7 percent. In a study of primary care practices, the prevalence of dyspareunia was 46 percent among sexually active women, with dyspareunia defined as pain during or after intercourse. […] As many as 60 percent of women experience dyspareunia when the term is broadly defined as episodes of pain with intercourse. […] There are few reports of clinical trials relating to dyspareunia, and much of the literature derives from expert opinion.
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https://www.nursingcenter.com/cearticle?an=00006205-202311000-00006&Journal_ID=54012&Issue_ID=6813630
Dyspareunia in women is a recurrent pain in the genital and/or pelvic area associated with sexual intercourse. Dyspareunia is associated with increased risk of sexual dysfunction and relationship distress, and it may impact an individual’s confidence, self-image, and self-esteem. […] Research conducted in the US indicates that between 7% and 58% of women suffer from dyspareunia. According to the American College of Obstetricians and Gynecologists, the prevalence is even higher, with a rate of up to 75% of women experiencing painful intercourse during their lives. […] Regardless of presentation, many women with dyspareunia are reluctant to report their symptoms to medical providers. Dyspareunia is therefore underreported despite its prevalence. Research has found that only 10% of women suffering from dyspareunia recognize it as sexual dysfunction.
#2 Painful sex (dyspareunia) in women: prevalence and associated factors in a British population probability survey – University of Technology Sydney
http://search.lib.uts.edu.au/discovery/fulldisplay/cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5638059/61UTS_INST:61UTS
Objective To estimate the prevalence of painful sex among women in Britain, and to explore associated sexual, relationship and health factors that should be considered in assessment. […] Painful sex was reported by 7.5% (95% CI 6.7â8.3) of sexually active women, of whom one-quarter experienced symptoms very often or always, for â¥6 months, and causing distress. […] Conclusion Painful sex is reported by a sizeable minority of women in Britain. Health professionals should be supported to undertake holistic assessment and treatment which takes account of the sexual, relationship and health context of symptoms. […] Painful sexâreported by 7.5% of women in Britainâis linked to poorer sexual, physical, relational and mental health.
#2 Dyspareunia (Painful Intercourse): Causes & Treatment
https://my.clevelandclinic.org/health/diseases/12325-dyspareunia-painful-intercourse
Dyspareunia is genital pain during or after sexual intercourse. 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. Pain during sex is more common in females, affecting 3 out of 4 at some point in their lives. Up to 28% of all people in the United States will experience painful sex at least once. Anyone of any age can experience painful sex. But its more likely to affect women who are past menopause (the average age of menopause is 51). Dyspareunia is a common condition that can have negative emotional and psychological effects. In addition to the physical pain, couples may experience a loss of intimacy or strain in their relationships. Pain during sex is more common in women, especially those who have reached menopause. The pain is often due to physical factors or medical conditions, but it can also be psychological or due to a mental health condition.
#2 Azthena logo with the word Azthena
https://www.news-medical.net/health/What-is-Dyspareunia.aspx
However, a study that looked primary care practices found dyspareunia in 46% of sexually active women (with the definition including pain during or after sexual intercourse). Moreover, postpartum dyspareunia was observed in 45% of women in a study from the US. […] If dyspareunia is broadly defined as episodic pain during sexual intercourse, the percentage of affected women climbs up to 60%. However, women that have such severe symptoms that they actually seek medical attention are part of a much smaller group (which is why the condition is not always recognized).
#2 Dyspareunia (Painful Intercourse): Causes, Treatments, and More
https://www.healthline.com/health/dyspareunia
Dyspareunia is more common in women than men. […] Around 75 percent of women have painful intercourse at some time, according to the American College of Obstetricians and Gynecologists (ACOG). […] Dyspareunia is one of the most common problems of postmenopausal women. […] Both women and men can experience dyspareunia, but the condition is more common in women.
#2 Dyspareunia (302.76) | Abnormal Psychology
https://courses.lumenlearning.com/atd-herkimer-abnormalpsych/chapter/dyspareunia-302-76/
In a survey of 329 women in 1993 at a gynecological clinic it was found that 7.7% of women experienced painful intercourse on most or all occasions. There is very little data on the prevalence of this disorder in men. However, studies have shown that when this disorder exists in men, it is usually caused by a medical problem. […] 60% of women experience genital pain before, during, or after intercourse at some point. However, the location and frequency varies among women. […] Estimates of the prevalence of male dyspareunia are sparse but appear to affect 3% to 5% of men in Western countries and 10% to 12% of men in the Middle East and Southeast Asia.
#2 Dyspareunia | 5-Minute Clinical Consult
https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/1688875/all/Dyspareunia?q=Interstitial+cystitis
The information presented in this chapter pertains to female dyspareunia. […] Predominant age: all ages. […] Predominant sex: female male. […] 50% of all sexually active women will report dyspareunia at some time. […] Up to 50% of menopausal women are affected by symptoms associated with genitourinary syndrome of menopause which includes a constellation of genital, sexual, and urinary symptoms associated with decreased estrogen levels. […] 10-20% of U.S. women are affected, varying by age and population.
#2 Painful intercourse (dyspareunia) // Middlesex Health
https://middlesexhealth.org/learning-center/diseases-and-conditions/painful-intercourse-dyspareunia
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. […] If an infection or medical condition contributes to your pain, treating the cause might resolve your problem. Changing medicines that can cause lubrication problems also might eliminate your symptoms. […] Treatment options vary depending on the cause of the pain.
#3 Dyspareunia
https://mobile.fpnotebook.com/Gyn/Sx/Dysprn.htm
Prevalence: 10-20% of women in the United States […] Age: More common on younger ages.