Sexual pain disorder

Abstract

Sexual pain disorder, combining the terms dyspareunia, vaginismus, genitopelvic pain, and penetration disorder, is common in women of reproductive and postmenopausal age worldwide (up to 34-45%) and is more often manifested as recurrent acute pain. A diagnosis of genitopelvic pain/penetration disorder (GPPD) is made when at least one of the following symptoms is present: persistent or recurrent difficulty with vaginal penetration; marked vulvovaginal or pelvic pain during vaginal intercourse and attempts of vaginal penetration; marked fear or anxiety about vulvovaginal or pelvic pain in anticipation, during or as a result of vaginal penetration; marked tension of the pelvic floor muscles during attempts of vaginal penetration. Additional criteria include the presence of the listed symptoms for at least 6 months, resulting in significant sexual distress that causes serious problems in the relationship and is not related to the effects of any substance or any other medical condition. The mechanisms of sexual pain are determined by a wide range of biological, psychiatric and social factors, which explains the difficulty in diagnosing and treating it, as well as the negative impact on sexual functioning in the couple. Timely multidisciplinary care for women suffering from a sexual pain disorder can effectively alleviate the condition and ensure marital sexual harmony in the couple. The modern range of treatment options includes both conservative and surgical treatment methods, the rational choice of which can significantly improve patients’ quality of life.