DYSPAREUNIA

By Joseph Hazan,M.D.,FACOG

Dyspareunia is painful intercourse.

It can occur due to physical or

psychological factors. It can be

occasional or persistent.

It can also occur after intercourse.

Causes:

1) Infection:

Herpes

Bacterial vaginosis

Pelvic Inflammatory Disease

Yeast

Trichomonas

Sexually Transmitted Infection

Urinary Tract Infection

2) Endocrine

Menopause

Breastfeeding

Estrogen lowering medications

3) Trauma

4) Medications that reduce libido

Antipsychotic medications

Some antidepressants

Some heart medications and

antihypertensives

5) Various:

Fibroids

Pelvic floor spasms- vaginismus

Vulvitis

Atrophic vaginitis

Vulvar Intraepithelial Neoplasia

Vulvar vestibulitis

Lichen sclerosus

Lichen planus

Endometriosis

Irritable Bowel Syndrome

Interstitial Cystitis-

Painful Bladder Syndrome

Constipation

Trigger point

Ovarian or tubal mass

Chronic pelvic pain

After a diagnosis is made

the treatment will be directed

to the specific situation.