Vaginal
pain
Definition
Pain
in the vaginal canal is usually associated with an underlying medical and/or
psychological condition.
Description
Vaginal pain is experienced usually during vaginal manipulation or
sexual intercourse. Approximately 50-85% of the causes are due to organic
(medical) conditions. However, it is typical for the medical condition to be
compounded by psychological issues such as depression and problems associated
with sexual identity. The primary entity concerns dyspareunia, a vaginal pain
experienced during sexual intercourse. The vagina has three physiological
functions: an outflow duct for menstrual discharge, to receive the penis during
sexual intercourse, and as the birthing canal. The overall prevalence for
dyspareunia is 20% (15% of women and 57% of men). A
significant percentage of breast cancer and hysterectomy patients demonstrated
sexual dysfunction.
Causes and symptoms
The causes can be categorized as organic, due to a medical condition
and/or psychological difficulties. Medical conditions can include chronic
diseases, minor ailments, breast cancer, and medications. Psychological cause
can be related to physical or sexual abuse. Pregnancy and hormonal changes
(decreased estrogen) have significant negative impact on sexual activity,
desire, and satisfaction. Dyspareunia can be divided into three types of pain:
superficial, vaginal, and deep. Superficial pain is associated with attempted
penetration. This is usually caused by changes in anatomy, irritative condition,
or vaginismus. Vaginal pain is associated with friction, indicating a problem
with lubrication and /or arousal disorders. Deep pain is related to thrusting
and is indicative of pelvic disease or an inability for pelvic relaxation.
Diagnosis
The diagnosis must be pursued with diligence and in a comprehensive
manner. A careful history and physical examination is essential. Procedures that
can be used include surgical investigation (laparoscopy) and treatment of the
underlying cause(s).
Treatment
Treatment is
directed at diagnosing the underlying condition, which can be medical and/or
psychological cause(s). Treatment can include surgery, hormonal therapy
(replacements), psychotherapy, and pain control protocols.
Prognosis
The prognosis
depends on the primary cause. If treatment is aggressively pursued and patient
compliance is satisfactory the overall outcome is favorable.
Prevention
There are no precise preventive measures since the condition can
result from normal aging and/or progressively worsening psychological disease.
Key Terms
Laproscopic surgery
A surgical procedure to correct or
diagnose an underlying disease.
