1. Definition: Dyspareunia is defined as recurrent or persistent genital pain experienced before, during, or after sexual intercourse.

2. Commonly Experienced: While it can affect both sexes, dyspareunia is more commonly reported in women.

3. Impact: Dyspareunia can have a significant impact on physical and mental health, as well as quality of life and relationships.

Physical Causes:

1. Vaginal Dryness: Lack of lubrication, especially after menopause or due to certain medications.

2. Infections: Genital or urinary tract infections (e.g., yeast infections, chlamydia).

3. Atrophic Vaginitis: Thinning of the vaginal lining, common in postmenopausal women.

4. Vulvodynia: Chronic pain in the vulva.

5. Endometriosis: A condition where tissue similar to the uterine lining grows outside the uterus.

6. Vaginismus: Involuntary spasms of the vaginal muscles.

7. Scar Tissue: From childbirth or other trauma.

8. Lichen Sclerosus: A condition that causes thinning and inflammation of the skin of the vulva.

9. Pelvic Floor Dysfunction: Problems with the muscles that support the pelvic organs.

Psychological Causes:

1. Anxiety or Fear: Associated with sexual intercourse or pain.

2. Past Trauma: History of sexual abuse or trauma.

3. Relationship Problems: Communication issues or dissatisfaction in the relationship.

4. Depression or Anxiety: Can contribute to or worsen pain.

Pain: The most common symptom is pain during sexual intercourse, which can be:

1. Superficial or Deep: Pain can occur at the vaginal opening or deeper in the pelvis.

2. Sharp, Burning, or Aching: The pain can feel like a sharp, burning, or aching sensation.

3. Before, During, or After: Pain can occur at any point during the sexual activity.

Other Symptoms:

1. Discomfort or Burning: Besides pain, there may be a general sense of discomfort or burning.

2. Bleeding: While not always associated with dyspareunia, bleeding during intercourse can be a sign of an underlying medical issue.

3. Lack of Sexual Desire or Arousal: Pain can lead to decreased sexual interest or difficulty achieving arousal.

Medical Evaluation: A thorough medical or gynecological examination is needed to identify the cause of dyspareunia.

Psychosexual History: Obtaining a psychosexual history can help identify any psychological factors contributing to the pain.

Treatment Options:

1. Addressing Underlying Causes: Treatment focuses on addressing the underlying cause, whether physical or psychological.

2. Lubricants: Can help with vaginal dryness.

3. Estrogen Therapy: May be helpful for postmenopausal women experiencing vaginal dryness.

4. Medications: Certain medications can help with pain or muscle spasms.

5. Physical Therapy: Pelvic floor physical therapy can help strengthen or relax pelvic floor muscles.

6. Counseling: Therapy can address psychological factors contributing to dyspareunia.

7. Vaginal Dilators: Can help women who have difficulty with penetration.

8. Surgery: In some cases, surgery may be necessary to address underlying conditions.

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