Managing Dyspareunia

Abstract

INTRODUCTION: Dyspareunia, or painful sexual intercourse, is a common symptom in women, affecting between 6 and 22% in the general population, and up to as many as 70% in certain populations. Despite its prevalence, discussion and treatment of the symptom are usually oriented toward the heterosexual healthy female, and patients are commonly divided by whether they are premenopausal or postmenopausal. This review examines the unique sets of symptoms, comorbidities, and physical limitations of different cohorts of women who present with dyspareunia and highlights the need for individualization of treatment for each cohort. METHODS: A PubMed review of the literature was conducted to examine the presentation and treatment of dyspareunia in cohorts including breast cancer survivors, lesbian or transgender patients, morbidly obese patients, terminally ill patients, and severely arthritic patients. RESULTS: Although information regarding the management of dyspareunia in different cohorts was limited, available templates and guidelines addressing dyspareunia presentation and management in these cohorts can be used to insure appropriate counseling and treatment for the diverse group of women cared for in the ambulatory setting. CONCLUSION: The causes and treatment of sexual pain differ depending on many factors, including overall patient health, patient mobility, presence or absence of a committed, sexually functional partner, sexual orientation, and age. Recommendations will be discussed that are geared to addressing risk factors that contribute to sexual pain and strategies will be reviewed that contribute to the effective management of women with dyspareunia.