- AdventHealth
D. Ashley Hill, MD, Medical Director of Obstetrics and Gynecology at AdventHealth Medical Group and Associate Director of the AdventHealth Graduate Medical Education Program's Department of Obstetrics and Gynecology, and AdventHealth family medicine physician Chantel A. Taylor, MD, published an article in American Family Physicians about dyspareunia in women. Defined as recurrent or persistent painful sexual intercourse, dyspareunia is a common condition that affects approximately 10 to 20 percent of women in the United States. While it can negatively affect women’s mental and physical health as well as their relationships, many who seek medical care for it report that they feel their concerns are dismissed. Left undiagnosed or untreated, dyspareunia can lead to sexual dysfunction, anxiety, depression, relationship distress and diminished quality of life.
Dr. Hill and Dr. Taylor encourage clinicians to understand the multiple risk factors for dyspareunia which include younger age, white race, lower socioeconomic status, depression, anxiety, low sexual satisfaction and a history of sexual abuse. In addition, women in the postpartum, perimenopausal or postmenopausal periods are also at increased risk as are those who have had a vacuum-assisted or forceps vaginal delivery, have had pelvic floor surgery or are breastfeeding. In addition, dyspareunia can occur with other conditions that cause pelvic pain, including fibromyalgia, irritable bowel syndrome and musculoskeletal disorders.
Clinicians should create safe and welcoming environments where they can take a complete sexual history and patients feel comfortable discussing their sexuality, including any symptoms they are experiencing and the location, intensity and duration of any pain. Physical examination is also critical to effectively diagnosing dyspareunia and should include visual inspection as well as sequential pressure with a cotton swab to assess for focal erythema or pain. In addition, a single-digit vaginal examination may be necessary to identify tender pelvic floor muscles, and a bimanual examination can assess for uterine retroversion and pelvic masses.
Causes of dyspareunia can be multifactorial and combining the patient history with the physical examination helps to determine the cause. Common diagnoses include inadequate lubrication, vaginal atrophy, pelvic floor dysfunction, vulvodynia, postpartum causes, vaginismus and endometrioses. Treatment focuses on the cause and may include lubricants, pelvic floor physical therapy, topical analgesics, vaginal estrogen, cognitive behavior therapy, vaginal dilators, modified vestibulectomy or onabotulinumtoxinA injections.
View the full document here.
Recent News
Physician leaders from AdventHealth’s emergency department, infectious disease, inpatient, pediatrics and pharmacy teams all collaborated to develop a respiratory virus testing algorithm to assist...
Thoracic surgeon Colleen Gaughan, MD, and her team at AdventHealth Celebration, recently became one of the first in the country to incorporate targeted imaging agent Cytalux (pafolacianine) as part of...
On the newest Inspiring Wholeness podcast, Obie Diaz, local morning radio show host, shares how a routine physical eventually led to two open heart surgeries.
AdventHealth recently began piloting a new Genomics Risk Assessment for Cancer and Early Detection (GRACE) program that combines the use of digital mammography, artificial intelligence (AI) technology...
AdventHealth Clinical Research Unit (CRU) Executive Director and Medical Director of Genitourinary Oncology Guru Sonpavde, MD, co-authored an article on the AMBASSADOR Phase III clinical trial results...
AdventHealth is accelerating the use of research-backed best practices for treating pediatric respiratory infections to combat antibiotic resistance and improve patient outcomes.
A promising new treatment for AFib patients called Pulse Field Ablation is first offered in Central Florida at AdventHealth and shows less damage to tissue.
Plastic and Reconstructive Microsurgeon Sabrina Pavri, MD, and Breast Surgeon Devina McCray, MD, recently began offering immediate neurotization after breast reconstruction, a new surgical technique...
Explore the importance of Hispanic representation in our community in this episode of the Inspiring Wholeness podcast.
Under the leadership of gynecologist and gynecological surgeon Omar Zwain, MD, AdventHealth for Women opened its new, multidisciplinary Comprehensive Fibroid Program at AdventHealth Winter Park in...
Under the leadership of Medical Director of Genomics and Personalized Health Majed Dasouki, MD, AdventHealth for Children is recruiting patients for a new Phase III clinical trial to evaluate the...
Hepato-pancreato-biliary (HPB) surgeon Andrew Guzowski, MD, performed AdventHealth’s first liver histotripsy, a non-invasive treatment for certain patients with unresectable liver tumors.