Dyspareunia: A Special Type of Chronic Pelvic Pain Essay
Such sexual dysfunctions include sexual desire disorders, sexual pain disorders, and sexual arousal disorders. Thus, if a person has difficulty in some stage of the response cycle or experiences pain during sexual intercourse, he/she, according to Miller, is positive in having a sexual dysfunction.
Sexual dysfunctions have many types. Sexual dysfunction is said to have sexual dysfunction as early as one’s sexual fantasies are increasing while the actual intercourse is decreasing and later on, the absence of it. This kind of sexual disorder is called Hypoactive Sexual Desire Disorder. However, before any sexual difficulty was supposed to be called a disorder or dysfunction, an individual must be affected first. (Bornstein J, Shapiro S, Rahat M, Goldshmid N, Goldik Z, Abramovici H, et al., 1996) Dyspareunia: A Special Type of Chronic Pelvic Pain Essay.
Furthermore, one rare sexual dysfunction is called the Sexual Aversion Disorder, wherein the person involved is relentlessly avoiding having genitals contact with his/her partner and thus, having a great effect on the sexual relationship.
Actually, there are so many kinds of sexual disorders, like Female Sexual Disorder, Male Erectile Disorder, Female and Male Orgasmic Disorder, Premature Ejaculation and of course the most popular among the categories of sexual disorders; dyspareunia. Dyspareunia is considered as a sexual pain disorder wherein it is a genital pain that comes with having sexual intercourse. Both sex partners can experience this; however, it is more common among women. It is said that dyspareunia is sometimes chronic in nature. (Butcher J, 1999)
On the other hand, Vertosick Frank (2000), discussed in his article in ‘behave net’ that if the presence of psychological factors played an important role in the pain felt by a person, like in the start, exactness, exacerbation or continuation of the pain, this is considered as a pain disorder. .
The presence of dyspareunia as a specific complaint should be a routine part of the gynecologic history. Dyspareunia: A Special Type of Chronic Pelvic Pain Essay. Even if the patient does not present with this as a chief complaint, the regular inclusion of the question of whether the patient has pain during intercourse can address emotional and physical concerns the patient may leave unspoken unless given the opportunity. Once identified, the symptoms should be dealt with by the clinician potentially as both an organic and as a sexual problem. This will allow the clinician to keep in mind that secondary sexual dysfunction can arise from initially simple organic problems. Patients should be advised at the onset that the process is ongoing and that therapy may be more than just one single treatment approach. Dyspareunia that occurs after a period of good sexual adjustment may be more amenable to an office-based counseling and educational approach, assuming that the patient and her partner are comfortable and cooperative in approaching the problem. Dyspareunia of long standing or in a more complicated relationship may require skills possessed by more highly trained professionals.
Pelvic pain is a common symptom that affects women worldwide and usually presents with variable range of severity, duration, and location. Several gynecological conditions may result in pelvic pain, and may have a variable presentation among patients. Pelvic pain creates a significant challenge and frustration to both patients and clinicians, which also creates a significant burden on the economy. It is necessary to tailor the management of pelvic pain to each individual patient to achieve optimal outcomes. Endometriosis, adenomyosis, and fibroids result in pelvic pain and may occur simultaneously. This review highlights some of the common gynecological etiologies of pelvic pain with a focus on anatomy, diagnosis, and management. Clin. Anat. 9999:1–5, 2018. © 2018 Wiley Periodicals, Inc. Dyspareunia: A Special Type of Chronic Pelvic Pain Essay.
About 10–15% of women of childbearing age have endometriosis. The present study aimed to investigate the relationship between the severity of symptoms of endometriosis and the spread as well as the stage of the disease on ultrasonography. The present cross-sectional study evaluates the relationship between the severity of endometriosis symptoms and the spread of disease on ultrasonography in patients with endometriosis.
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Considering different analyses, the cumulative size of posterior deep infiltrative endometriosis (DIE) (less than 1 cm) is significantly correlated with minimal severity of dyspareunia and chronic pelvic pain. The incidence of dyspareunia was more prevalent in patients with complete stenosis of Douglas pouch than those with incomplete stenosis. Furthermore, the incidence of severe and very severe pain in patients with Douglas pouch stenosis is relatively higher than that in patients without stenosis. Only dyspareunia is related to the stage of endometriosis, and patients with dyspareunia are five times more at risk of a higher stage of the disease. The severity of dyspareunia is related to the stage of endometriosis and the severity of Douglas pouch stenosis.Dyspareunia: A Special Type of Chronic Pelvic Pain Essay. The results showed a correlation between chronic pelvic pain and r-ASRM score (revised American Society for Reproductive Medicine score).
Endometriosis refers to the extrauterine presence of endometrial glands and stroma leading to reactive inflammation and fibrosis [1].
Endometriosis affects 10–15% of women of childbearing age. Most of the patients are in the 18–25 age range [2]. The prevalence of the disease is even higher in symptomatic individuals (infertile individuals = 50%, patients with chronic pelvic pain = 50–90%) [3, 4]. Endometriosis may cause severe painful symptoms such as dysmenorrhea, dyspareunia, and chronic pelvic pain while doing daily activities. The painful and chronic symptoms of this disease result in a poor quality of life in most of the patients [5,6,7]. The ovaries are one of the most common sites of endometriosis. Ovarian endometrioma is a pathognomonic manifestation of endometriosis. Endometrioma is a type of cyst formed from bloody ectopic endometrial glands inside the ovary. This cyst has fibrous capsules and contains blood products [1]. Dyspareunia: A Special Type of Chronic Pelvic Pain Essay.
Deep infiltrative endometriosis (DIE) is a specific form of endometriosis which refers to endometrial implants above 5 mm penetrating the peritoneal surface. These implants are highly active and almost associated with pelvic pain symptoms. The most common effected areas for these implants include posterior areas, uterosacral ligament (USL), torus uterus (the retro-cervical part of uterine where uterosacral ligaments join there), posterior wall of the vagina, and posterior wall of the rectum [8]. Although clinical findings may suggest the disease, imaging is needed for definitive diagnosis [4]. According to The American College of Obstetricians and Gynecologists (ACOG), transvaginal ultrasonography (TVS) is the first method found for studying endometriosis, and magnetic resonance imaging (MRI) is used if rectovaginal or bladder involvement is suspected [1, 4]. The value of ultrasound in the diagnosis of endometriosis has been confirmed. Several papers have shown that TVS is comparable and even better than MRI [9]. TVS is highly specific for the detection of DIE in uterosacral ligaments, rectovaginal septum, vagina, and bladder [10]. The classic appearance of endometrioma in ultrasound examination is homogenous, and hypoechoic cystic ovarian lesion with low-level internal echo and without internal blood flow is displayed [1, 11] (Fig. 1a). Dyspareunia: A Special Type of Chronic Pelvic Pain Essay.