Dyspareunia refers to pain experienced immediately before, during, or after intercourse. Diagnosis of dyspareunia is made by history and physical examination. Useful questions include the onset, duration, and circumstances in which this problem occurred, the location of the pain (e.g., superficial, deep, unilateral, bilateral), and whether it is specific to a particular partner or practice. Physical exam may reveal peri-neal trauma or vaginal infection, vaginal mucosal atrophy, or other anatomic factors (e.g., vaginal septa, partial vaginismus). Emotional factors may contribute, such as ambivalence or distaste regarding the sexual relationship, as well as the sequelae of childhood abuse. Inadequate lubrication, relationship difficulties, poor sexual technique or a rough or abusive partner can cause dyspareunia.

Treatment of physiologic dyspareunia caused by atrophic vaginitis may require vaginal estrogen. Vaginal infections must be diagnosed and treated. For poor lubrication, supplemental water-based lubrication may be sufficient. Deep dyspareunia is often caused by overvigorous penetration or excess cervical pressure and may respond to brief educational interventions. Many people do not realize that penises and vaginas vary in length, and the vagina may not stretch to accommodate full penile engulfment. Changing position to allow the woman to control the amount of cervical pressure may ameliorate the dyspareunia. Referral for sex therapy for the couple may prove helpful. In some cases, the patient may be able to bring about change in the sexual relationship with sufficient information and assertiveness. If dyspareunia is the result of deliberate carelessness or abuse by the partner, ending the relationship is usually the only reasonable option.

Bacterial Vaginosis Facts

Bacterial Vaginosis Facts

This fact sheet is designed to provide you with information on Bacterial Vaginosis. Bacterial vaginosis is an abnormal vaginal condition that is characterized by vaginal discharge and results from an overgrowth of atypical bacteria in the vagina.

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