Management of Normal and Altered
Female Reproductive Function
DYSPAREUNIA
Dyspareunia
(difficult or painful intercourse) is increasing in incidence and can be
superficial, deep, primary, or secondary. This problem can be embarrassing for
women to discuss be-cause they may believe that it is their problem if their
partner is not experiencing discomfort. Dyspareunia may occur at the be-ginning
of, during, or after intercourse and may be related to injury during childbirth,
lack of lubrication, a history of incest, sexual abuse, or assault,
endometriosis, pelvic infection, vaginal atrophy with menopause,
gastrointestinal disorders, fibroids, urinary tract infection, STDs, or
vulvodynia (vulvar pain that affects women of all ages without any discernible
physical cause). Because dyspareunia is often due to lack of vaginal
lu-brication, use of vaginal lubricants can be suggested. Depending on the
cause of dyspareunia, antidepressants may be prescribed in selected patients,
and surgery to expand or repair the vaginal opening is occasionally needed.
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