Dyspareunia pathophysiology: Difference between revisions

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{{Dyspareunia}}
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==Overview==
==Overview==
[[Dyspareunia]] is caused by  [[medical causes]], [[psychological]] problems, and pathophysiology of dyspareunia vary based on the underlying causes. For example, estrogen deficiency causes atrophic vaginitis or ectopic uterine tissues in endometriosis causes dyspareunia. Psychological problems can cause dyspareunia.
[[pathophysiology]] of genito-pelvic pain/ penetration disorder(GPPPD) can be considered as multifactorial, [[multisystemic]], or [[complex]].


==Pathophysiology==
==Pathophysiology==
*[[Vaginismus]]: This is the result of a conditioned reflex of the [[pubococcygeus muscle]], which is sometimes referred to as the 'PC muscle'. The reflex causes the muscles in the vagina to tense suddenly, which makes any kind of vaginal penetration -- including [[sexual penetration]] -- either painful or impossible.<br>
[[Pathophysiology]] of [[sexual pain disorders]] in female can be considered as:<ref> 10.1007/978-3-319-52539-6_20</ref><ref name="pmid24811097">{{cite journal |vauthors=Graziottin A, Skaper SD, Fusco M |title=Mast cells in chronic inflammation, pelvic pain and depression in women |journal=Gynecol. Endocrinol. |volume=30 |issue=7 |pages=472–7 |date=July 2014 |pmid=24811097 |doi=10.3109/09513590.2014.911280 |url=}}</ref>
*[[Endometriosis]]:The exact [[pathogenesis]] of [[endometriosis]] is not clear; several theories have been set forth. The Sampson theory of retrograde [[menstruation]], the coelomic [[metaplasia]] theory, and the [[lymphatic]] and [[vascular]] dissemination theory explain the implantation and invasion of the [[Endometrium|endometrial tissue]] outside the [[uterine cavity]]. [[Immunological|Immunologic]] factors and [[genetic]] factors are also thought to play a role in the pathogenesis of [[endometriosis]].<br>
*'''Multifactorial'''
*[[Vulvodynia]]: A wide variety of possible causes and treatments for vulvodynia are currently being explored. Some possible causes include: [[allergy]] or other sensitivity to chemicals or organisms normally found in the environment, [[autoimmune disorder]] similar to [[Lupus Erythematosus|lupus erythematosus]], chronic tension or spasm of the muscles of the vulvar area, [[infection]], injury, chemical sensitivity and [[neuropathy]]. Some cases seem to be negative outcomes of genital surgery, such as a labiectomy.<br>
*'''Multisystemic'''
*Pathophysiology of Isolated painful ejaculation depends on the underlying cause such as [[Urethritis]], [[Prostatitis]], [[Epididymitis]], [[Orchitis]], [[Abdominal abscess]], Penile prosthesis, [[Bladder cancer]], Intra-abdominal tumors, [[Prostate cancer]], Vesical calculi, [[Benign prostatic hyperplasia]] (BPH), [[Urethral stricture]], Pelvic musculature spasm, Radical prostatectomy, Transurethral resection of the prostate (TURP),Vasectomy, [[Frenulum breve]]
*'''Complex'''
'''Multifactorial''':
*[[Biological]], [[psychosexual]], relational factors can coexist and interact to perpetuate and maintain a woman’s pain response in a woman complaining of [[Coitus|coital]] pain. Over time, these different factors may act as predisposing, precipitating, or perpetuating sexual pain disorders.<br>
'''Multisystemic''': sexual function involves:
*[[Nervous system]]
*[[Endocrine system]]
*[[Vascular system]]
*[[Immunological system|Immunological systems]]
*[[Vaginal]] ecosystem: Vaginal receptiveness may be further modulated by; psychosexual, [[mental]], [[interpersonal]] factors that may result in poor [[arousal]] with [[vaginal dryness]]. Fear of penetration, general [[muscular]] arousal secondary to [[anxiety]], defensive [[contraction]] of the peri-vaginal [[muscles]], leading to lifelong [[vaginismus]].<br>
 
 
'''Complex:'''Coital pain is greater than the simple peripheral [[tissue]] damage that may initially trigger the [[nociceptive]] component. When It becomes [[chronic]], the [[pathophysiology]] of pain may gradually shift from [[nociceptive]], a friend signal that should induce self-protection and defense, to [[neuropathic]], with progressive involvement of the [[CNS]].<ref> 10.1007/978-3-319-52539-6_20</ref>
* If pain is due to a physical cause, the [[pathophysiology]] of the underlying cause should be considered.
 
The [[pathophysiology]] of [[dyspareunia]] in males depends on the underlying cause, psychosexual and relational factors.


==References==
==References==
{{reflist|2}}
{{reflist|2}}
{{WH}}
{{WS}}


[[Category:Needs content]]
[[Category:Gynecology]]
[[Category:Gynecology]]
[[Category:Psychiatry]]
[[Category:Psychiatry]]
[[Category:Sexual and gender identity disorders]]
[[Category:Sexual and gender identity disorders]]

Latest revision as of 16:44, 28 September 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

Overview

pathophysiology of genito-pelvic pain/ penetration disorder(GPPPD) can be considered as multifactorial, multisystemic, or complex.

Pathophysiology

Pathophysiology of sexual pain disorders in female can be considered as:[1][2]

  • Multifactorial
  • Multisystemic
  • Complex

Multifactorial:

  • Biological, psychosexual, relational factors can coexist and interact to perpetuate and maintain a woman’s pain response in a woman complaining of coital pain. Over time, these different factors may act as predisposing, precipitating, or perpetuating sexual pain disorders.

Multisystemic: sexual function involves:


Complex:Coital pain is greater than the simple peripheral tissue damage that may initially trigger the nociceptive component. When It becomes chronic, the pathophysiology of pain may gradually shift from nociceptive, a friend signal that should induce self-protection and defense, to neuropathic, with progressive involvement of the CNS.[3]

  • If pain is due to a physical cause, the pathophysiology of the underlying cause should be considered.

The pathophysiology of dyspareunia in males depends on the underlying cause, psychosexual and relational factors.

References

  1. 10.1007/978-3-319-52539-6_20
  2. Graziottin A, Skaper SD, Fusco M (July 2014). "Mast cells in chronic inflammation, pelvic pain and depression in women". Gynecol. Endocrinol. 30 (7): 472–7. doi:10.3109/09513590.2014.911280. PMID 24811097.
  3. 10.1007/978-3-319-52539-6_20