Recent epidemiological surveys indicate that dyspareunia affects between 15% and 21% of women between the ages of 18 and 59 (7-9). Although dyspareunia is a common problem, many sufferers do not pursue treatment because of the embarrassment associated with talking about genital pain and sexuality. Of those who do consult, many do not receive adequate care; it is reported that 40% of dyspareunic women who sought treatment did not receive any diagnosis even after multiple consultations (8). These women may also be told, after several potentially invasive and painful evaluations, that all is well physically, implying either that their pain is "not real" or that they suffer from psychological problems.
In addition to problems encountered in the health care system, women with dyspareunia suffer negative impacts in both sexual and nonsexual areas of their lives. In terms of sexuality, women with dyspareunia report lower frequencies of intercourse, lower levels of sexual desire, arousal, and pleasure, and less orgasmic success than non-affected women (10-12). It is therefore not surprising that women with dyspareunia also report difficulties with relationship adjustment and psychological distress, including depression and anxiety (10). Outside of sexuality and intimate relationships, activities such as gynecological examinations, bicycle riding, or sitting for long periods of time may also be affected (10,11,13,14). Given the significant negative impact dyspareunia can have on multiple aspects of life, it is crucial to provide women suffering from this condition with information, validation of their pain, and appropriate treatment. However, the classification of dyspareunia has precluded this in many cases by focusing on the sexual aspects of dyspareunia, to the exclusion of focusing on the pain and the complexity of factors (e.g., emotional, interpersonal) that are involved.
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