DYSPAREUNIA
Painful introduction of the male organ or pain during intercourse are
both considered under this title. The mnemonic to use here is MINT.
This can then be applied to the anatomic structures as we explore the
genital tract. Of course, psychologic disturbances are probably the most
common causes of this disorder. They are discussed after the anatomic
causes.
M—Malformations include a disproportionately large or deformed male
organ (not amusing to the man in this predicament), an unruptured or thick
hymen, vaginal stenosis, a retroverted uterus, and prolapsed ovaries.
I—Inflammatory disorders include vulvitis and bartholinitis (often
related to gonorrhea), various forms of vaginitis (bacterial,
trichomoniasis, and moniliasis), and salpingo-oophoritis. (Note that an
inflamed uterus and cervix are only infrequently associated with
dyspareunia.) Inflammatory lesions of nearby structures are important. Thus,
a urethral carbuncle, urethritis, cystitis, hemorrhoids, and anal fissures
can cause dyspareunia.
N—Neoplasms causing dyspareunia are leukoplakia vulvitis, kraurosis
vulvae, carcinoma of the vulva and vagina, ovarian cysts, and carcinoma.
When uterine and cervical carcinomas extend beyond the genital tract,
dyspareunia is present. Any neoplasm of the bladder and rectum that has
extended into the genital tract will undoubtedly cause dyspareunia.
T—Traumatic disorders include too-frequent intercourse and
masturbation. Introduction of the male organ before adequate foreplay has
created a lubricated vagina is another cause. The male patient should be
instructed in the gentle introduction of the organ.
Women in menopause may require lubricants to prevent local trauma,
because the vagina remains dry even after sexual excitement because of lack
of hormonal secretion.
Discovery of psychogenic causes often requires thorough psychoanalysis. A
careful evaluation for sexual abuse must be done. Incest, guilt from
masturbation, and latent homosexuality are a few of the problems that may be
encountered.
Approach to the Diagnosis
The approach to this diagnosis includes an examination of both male and
female genital organs and counseling by an understanding physician if these
examinations are negative.
Other Useful Tests
-
Pregnancy test
- Vaginal smear and culture
- Urinalysis and culture
- Sonogram (ectopic pregnancy, ovarian cyst, tubo-ovarian abscess)
- Laparoscopy
- Gynecology consult
- Psychiatric consult
Pictures
Book Source Details
- Book Title: Differential Diagnosis in Primary Care
- Author(s): R. Douglas Collins MD, FACP
- Year of Publication: 2007
- Copyright Details: Differential Diagnosis in Primary Care, Copyright © 2007 Lippincott Williams & Wilkins.
Other Book Chapters Related to Female sexual symptoms
Read excerpts from these other book chapters related to Female sexual symptoms:
Medical Books Excerpts
- Dyspareunia
- "Professional Guide to Diseases (Eighth Edition)" (2005)
- [ read ]
- Dyspareunia
- "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
- [ read ]
- Menorrhagia
- "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
- [ read ]
- Menorrhagia
- "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
- [ read ]
- Vaginal Discharge
- "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
- [ read ]
Copyright Details: Differential Diagnosis in Primary Care, Copyright © 2008 Williams & Wilkins.
More About Causes of Female sexual symptoms
» Next page: VAGINAL DISCHARGE (Differential Diagnosis in Primary Care)
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