- Wayne JG Hellstrom, MD
Wayne JG Hellstrom, MD
- Professor of Urology
- Chief, Section of Andrology
- Tulane University Health Sciences Center
The term “dyspareunia” refers to pain associated with sexual intercourse, which can affect men as well as women and cause significant psychologic distress. Male dyspareunia is defined as recurrent or persistent genital or pelvic pain with sexual activity or sexual dysfunction that is present for three months or longer . The condition often leads to embarrassment and may be difficult for the patient and clinician to discuss openly.
Most studies describing male dyspareunia are small case reports. Few long-term studies have been published, with the majority of reports on associated conditions such as chronic prostatitis or Peyronie's disease.
This topic will focus on the epidemiology, etiology, classification, diagnosis, and management of male dyspareunia that is not the result of infectious conditions (eg, acute urethritis, acute cystitis, acute prostatitis), which are discussed elsewhere. (See "Approach to infectious causes of dysuria in the adult man".)
A general overview of male sexual dysfunction, chronic prostatitis/pelvic pain in men, and dyspareunia in women are also discussed separately. (See "Overview of male sexual dysfunction" and "Chronic prostatitis/chronic pelvic pain syndrome" and "Approach to the woman with sexual pain".)
Studies have reported that approximately 1 to 5 percent of male patients suffer from pain with sexual intercourse [2-4]. However, because of the social stigma associated with male sexual disorders, underreporting appears to be common. It is not known whether the low reported incidence of dyspareunia in males represents a lack of disclosure or reflects the true infrequency of this condition. In the absence of an identifiable genitourinary abnormality, uncircumcised men are more likely than circumcised men to report dyspareunia . This association is not entirely explained by scratches, abrasions, cuts, and bleeding with sexual intercourse in uncircumcised men.
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- ETIOLOGY AND CLASSIFICATION
- Isolated ejaculatory pain
- Chronic prostatitis/chronic pelvic pain syndrome
- Medical causes
- Other causes of sexual pain
- Initial evaluation
- - History
- - Physical examination
- - Laboratory studies
- Determining the etiology
- Addressing the underlying cause
- Symptomatic therapy
- Psychologic counseling/behavioral therapy
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS