Dyspareunia

Question 1

Painful intercourse can be considered as

Answer 1

superficial (pain felt on insertion)

or

deep (pain on deep penetration)

Question 2

Causes of superficial dyspareunia:

Answer 2

physiological—inadequate lubrication

provoked vestibulodynia syndrome

vaginitis, esp. chronic candidiasis

vulvar dermatoses

postnatal perineal scarring

vulvovaginal atrophy

incompletely ruptured hymen

urethritis

vaginismus

Question 3

Causes of deep dyspareunia:

Answer 3

endometriosis

PID

pelvic adhesions

ovarian and uterine tumours

retroverted uterus

post natal

Question 4

Management involves

Answer 4

treating the organic cause

advice about use of lubricants

oestrogen creams

perhaps lignocaine gel.