Dyspareunia: Difference between revisions
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A pelvic assessment, including an internal exam, performed by a trained medical professional with the informed consent of the patient. | A pelvic assessment, including an internal exam, performed by a trained medical professional with the informed consent of the patient. | ||
Outcome Measures | '''Outcome Measures''' | ||
The Female Sexual Destress Scale-Revised (FSDS-R): a single item from this scale may be a useful tool in quickly screening for sexual distress in middle-aged women.<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4380908/</ref> | The Female Sexual Destress Scale-Revised (FSDS-R): a single item from this scale may be a useful tool in quickly screening for sexual distress in middle-aged women.<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4380908/</ref> | ||
Revision as of 23:52, 20 February 2019
Dyspareunia[edit | edit source]
*Page currently undergoing editing, please check back soon.
Definition[edit | edit source]
Dyspareunia is defined as persistent genital pain that occurs during sexual intercourse.[1]
Clinically Relevant Anatomy[edit | edit source]
Clinical Presentation[edit | edit source]
Subjective History
Symptoms
Individuals may present with pain that occurs at entry during penetration, with deep penetration or lasting post-penetration. Pain associated with the insertion of a tampon could also be another subjective report. Words used to describe pain may be (but are not limited to): "throbbing" "burning" or "aching."
Objective Assessment
A pelvic assessment, including an internal exam, performed by a trained medical professional with the informed consent of the patient.
Outcome Measures
The Female Sexual Destress Scale-Revised (FSDS-R): a single item from this scale may be a useful tool in quickly screening for sexual distress in middle-aged women.[2]
Level of dyspareunia pain (0-10)
Management / Interventions[edit | edit source]
Medical management
Ensure that the patient has been screened by a physician to rule out any differential diagnoses or address co-existing diagnoses that are out of the physiotherapy scope of practice.
Physiotherapy
If hypertension of the pelvic floor muscles is an issue, then teaching the patient how to relax these muscles can increase comfort during initial and deep penetration.
Additional Considerations
- If this has become a chronic issue, addressing principles of centralized pain and explaining this to the patient can be helpful and informative.
- The use of a multidisciplinary approach with the inclusion of a physician and a counselling therapist could also beneficial.
- Women in the post-menopausal phase of life, may be dealing with dyspareunia due to changes in hormone levels which affects the genital tissue. If this is a contributing factor, it should be addressed by a physician.
- Stress can contribute to the tension of the pelvic floor muscles and this could be managed through counselling.
Potential Contributing Factors[edit | edit source]
- skin irritation (ie. eczema or other skin problems in the genital region)[1]
- endometriosis
- vestibulodynia
- vulvodynia[3]
- interstitial cystitis[3]
- fibromyalgia[3]
- irritable bowel syndrome[3]
- pelvic inflammatory disease[4]
- depression and/or anxiety[4]
- post-menopause[4]
Resources[edit | edit source]
References[edit | edit source]
- ↑ 1.0 1.1 https://www.mayoclinic.org/diseases-conditions/painful-intercourse/symptoms-causes/syc-20375967
- ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4380908/
- ↑ 3.0 3.1 3.2 3.3 Reed BD, Harlow SD, Sen A, et al. Relationship between vulvodynia and chronic comorbid pain conditions. Obstet Gynecol 2012; 120:145.
- ↑ 4.0 4.1 4.2 Latthe P, Mignini L, Gray R, et al. Factors predisposing women to chronic pelvic pain: systematic review. BMJ 2006; 332:749.
