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Tests and diagnosis
By Mayo Clinic staffA medical evaluation for dyspareunia usually consists of:
- A thorough medical history. Your doctor may ask when your pain began, exactly where it hurts, how it feels, and if it happens with every sexual partner and every sexual position. Your doctor may also inquire about your sexual history, surgical history and previous childbirth experiences. Don't let embarrassment stop you from giving candid answers. These questions provide clues to the cause of your pain.
- A pelvic examination. During a pelvic exam, your doctor can check for signs of skin irritation, infection or anatomical problems. He or she may also try to identify the location of your pain by applying gentle pressure to the genital area and pelvic muscles. A visual examination of the vaginal passage, using an instrument called a speculum to separate the vaginal walls, may be performed as well. Some women who experience painful intercourse are also uncomfortable during a pelvic exam, no matter how gentle the doctor is. You can ask to stop the exam at any time if it's too painful.
- Additional tests. If your doctor suspects certain causes of painful intercourse, he or she might also recommend a pelvic ultrasound.
References
- Biggs WS. Sexual pain disorders. In: Rakel RE. Textbook of Family Medicine. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/das/book/body/191205553-4/0/1481/0.html#. Accessed Nov. 18, 2011.
- Lenz G. Emotional Aspects of Gynecology: Sexual function and dysfunction. In: Katz VL, et al. Comprehensive Gynecology. 5th ed. Philadelphia, Pa.: Mosby Elsevier; 2007. http://www.mdconsult.com/das/book/body/208746819-4/0/1524/0.html. Accessed Nov. 18, 2011.
- Kurss DI, et al. Dyspareunia. In: Ferri FF. Ferri's Clinical Advisor 2012: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05611-3..C2009-0-38601-8--TOP&isbn=978-0-323-05611-3&uniqId=291436269-101. Accessed Nov. 18, 2011.
- Moore CK. Female sexual function and dysfunction: Diagnosis. In: Wein AJ, et al. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/das/book/body/208746819-6/0/1445/0.html. Accessed Nov. 18, 2011.
- Stewart EG. Causes and treatment of sexual pain in women. http://www.uptodate.com/home/index.html. Accessed Nov. 18, 2011.
- Stewart EG. Approach to the woman with sexual pain. http://www.uptodate.com/home/index.html. Accessed Nov. 18, 2011.
- Ask Mayo Expert. What are the treatment options for managing vaginal symptoms of urogenital atrophy in women with a history of breast cancer? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2011.
- Bachmann G, et al. Treatment of vaginal atrophy. http://www.uptodate.com/home/index.html. Accessed Nov. 18, 2011.
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