Dyspareunia is pain with sexual intercourse and is not an uncommon complaints expressed by many of our female patients.

The actual cause is unknown but it appears to have a bi-modal age distribution between woman from 20-30 years of age and those who are 50-60 years old.

Common causes of dyspareunia found in the urological setting include:

  • Atrophic vaginitis
  • Urinary tract infection
  • Interstitial cystitis
  • Erosion of implantable mesh
  • Tissue damage from radiation
  • Organ prolapse
  • Urethral abscess / vaginal cysts
  • Sexual transmitted diseases
  • Vaginismus

Workup includes a detail history and a thorough examination.  Other evaluations may include:

  • Urinalysis and urine culture
  • Blood and vaginal swabs to screen for sexual transmitted diseases
  • Cystourethroscopy

Treatment for Dyspareunia

Treatment for dyspareunia varies tremendously. If a direct cause of the pain is identified such as a urinary tract infection or a urethral abscess then treatment for the specific disorder will usually resolve the condition.

Otherwise, it may require a multimodality approach depending on the circumstances.

For women who are pre-menopausal, the solution maybe pelvic floor relaxation with the help of a physical therapist along with the use of water-based lubricants.

For others who are post-menopausal, the use of supplemental estrogen (if appropriate) along with the use of water-based lubricants has been proved effective.

If there is significant vaginal and/or pelvic organ prolapse then repair of this condition maybe indicated.

A more recent development for dyspareunia in women who suffers from atrophic vaginitis is the use of a CO2 laser therapy (MonaLisaTouch) to encourage regrowth of normal vaginal tissue.  It is a simple and quick procedure that can be performed in the physician office.

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