Sexual Pain Disorders: Dyspareunia and Vaginismus

Evaluation of a rural nurse-led clinic for female sexual dysfunction

“…28 It is not uncommon for woman to see numerous health professionals before they receive the right assistance. 29 Participants that were referred to specialist metropolitan medical services were able to access a subsidy towards travelling costs through the health department's Patient-Assisted Travel Scheme.…”

Menopause and sexuality: key issues in premature menopause and beyond

“…In stable relationships, counselling to both partners is a crucial part of the diagnosis and management. Accurate physical examination is mandatory, given the importance of biological disruptions associated to PM, with focus on trophism of external genitalia, vagina and vaginal pH, pelvic floor tonicity, and “pain map,” in case of dyspareunia 5,25 . A poor quality of genital sexual feedbacks is usually an underevaluated contributor of loss of sexual desire in PM and menopausal women.…”

“…Vaginal estrogenic treatment is indicated when the genital arousal disorder causes and/or is associated with vaginal dryness, dyspareunia, post‐coital cystitis, urogenital atrophy, and/or urinary incontinence, mostly of the urge type 5,25 . Accelerated urogynecological comorbidity will be delayed with appropriate HT.…”

“…Dyspareunia requires a careful pathophysiologic understanding of its complex biological etiology (muscular, endocrine, vascular, nervous, immune, iatrogenic) and meaning, to design an effective treatment 25 . Friction introital dyspareunia, secondary to vaginal dryness, may benefit from vaginal ET.…”

“…Vaginal estrogenic treatment is indicated when the genital arousal disorder causes and/or is associated with vaginal dryness, dyspareunia, post-coital cystitis, urogenital atrophy, and/or urinary incontinence, mostly of the urge type. 5,25 Accelerated urogynecological comorbidity will be delayed with appropriate HT. Early vaginal estrogenic treatment, pelvic floor stretching and vaginal moulds, to maintain vaginal elasticity, optimal length, and "habitability" during pelvic or vaginal radiotherapy for squamous cervical cancer, may minimize the impact of radiotherapy on vaginal tissue.…”