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DYSPAREUNIA: PAIN DURING SEXUAL INTERCOURSE

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DYSPAREUNIA: PAIN DURING SEXUAL INTERCOURSE

Post by pmmutiti on Sat Jun 07, 2008 3:01 pm



What Is It?

Dyspareunia (Pain During Intercourse)

Definition of Dyspareunia: This is an abnormal pain during sexual intercourse. It may result from abnormal conditions of the genitalia, dysfunctional psychophysiologic reaction to sexual union, forcible coition, or incomplete sexual arousal.

Description of Dyspareunia

Dyspareunia is pain that occurs only (or primarily) during sexual intercourse. It is not a disease, but rather a symptom of an underlying physical or psychological disorder.

The pain, which can be mild or severe, may appear in the genitals, the pelvic region, or the lower back. The condition is much more common among women.

Causes and Risk Factors of Dyspareunia

For women, causes include vaginismus, a psychological condition characterized by spasms of the vaginal muscles and insufficient vaginal lubrication; scars from an episiotomy (an incision made to facilitate childbirth); thinning and dryness of the vaginal wall due to estrogen deficiencies accompanying menopause, or breastfeeding; and inadequate foreplay.

Disorders that may cause pain upon deep vaginal penetration include:

* Pelvic inflammatory disease

* Ovarian cysts

* Endometriosis

* Varicose veins in the pelvis

* Ectopic pregnancy

Other causes include:

* Infections, such as sexually transmitted diseases, which may irritate the vaginal walls or the skin of the penis

* Bladder or other urinary tract disorders such as cystitis or urethritis

* Cancer in the sex organs or the pelvic region

* Arthritis, especially in the lower back

* Allergies to spermicides or to the latex in condoms and diaphragm

For men, the condition can result from such disorders as irritation of the skin of the penis due to an allergic rash; physical abnormalities of the penis, like a tight foreskin or a bowed erection; and infections of the prostate gland or testes.

Another frequent explanation for painful intercourse is thinning and drying of the vaginal tissue as menopause begins. This happens because the body is producing less and less of the estrogen that is needed to maintain moist vaginal tissue. As the vagina's ability to make its own mucus declines, it becomes itchy, dry, and painful, leading to discomfort during intercourse.

Symptoms of Dyspareunia

Symptoms include a burning, ripping, tearing, or aching sensation associated with penetration. The pain can be at the vaginal opening, deep in the pelvis, or anywhere between. It may also be felt throughout the entire pelvic area and the sexual organs and may occur only with deep thrusting.

Treatment of Dyspareunia

Treatment is aimed at identifying and properly treating the underlying disorder.

Medications are prescribed to treat infections, if they exist. If an allergy to latex is suspected, alternative methods of contraception should be considered. If the spermicide is causing discomfort, try a different brand or consider using alternate methods of birth control.

A water-based lubricant may help ease discomfort and friction. However, avoid oil-based lubricants, such as petroleum jelly, since they dissolve the latex in condoms and may actually promote infection.

Insertion of a graduated set of dilators into the vagina may be used to treat vaginismus. Pain during intercourse due to an episiotomy generally subsides over time. Psychological counseling may be advised if no underlying physical abnormalities can be identified.

Questions To Ask Your Doctor About Dyspareunia

What is causing the pain?

Is the condition allergy based?

Would estrogens help?

What is the best lubricant to use?

Will counseling help?

Diagnosis

Dyspareunia typically is diagnosed based on your symptoms. Your medical and sexual history and your physical examination will help your doctor to determine the cause of your symptoms.

Distinguishing pain that occurs with touching the genitals or early penetration from pain that occurs with deeper penetration is a clue to the cause of your symptoms. Therefore, your doctor will ask you questions about the exact location, length and timing of your pain. He or she also will ask you:

If there was ever a time you had painless intercourse, or if you have always had dyspareunia
If you have enough natural lubrication, and if your symptoms improve if you use commercially available lubricants
About your sexual history (to help assess your risk for sexually transmitted infections)
If you have ever been sexually abused, or had a traumatic injury involving your genitals
In addition:

If you are middle-aged, your doctor will ask whether you are experiencing irregular periods, hot flashes or vaginal dryness, symptoms suggesting that you may have atrophic vaginitis.
If you are a new mother, your doctor will ask whether you are breastfeeding your baby, because breastfeeding also can lead to vaginal dryness and dyspareunia

During the physical examination, your doctor will check your vaginal wall for signs of dryness, inflammation, infection (especially yeast or herpes infection), genital warts and scarring. Your doctor also will do an internal pelvic examination to look for abnormal pelvic masses, tenderness or signs of endometriosis. He or she also may suggest that you speak with a counselor to determine whether a history of sexual abuse, trauma or anxiety may be contributing to your symptoms.

Expected Duration

How long your symptoms last depends on the cause. If you have vaginal dryness from inadequate lubrication, the symptoms will improve rapidly if you use a commercially available lubricant or if you are more aroused before intercourse. If you have vaginal dryness from atrophic vaginitis, your symptoms will improve with an estrogen cream placed in the vagina. You should discuss this with your physician. Oral estrogen therapy can increase the risk of breast cancer and heart disease, but vaginal formulas are considered safe for most people. If you have a urinary tract or vaginal yeast infection, the dyspareunia typically goes away within one week of antibiotic or antifungal therapy. If you have a sexually transmitted disease, you may need longer, more intensive treatments with antibiotics may be necessary to clear the condition. Skin diseases, usually will improve with the use of steroid creams, but often require long-term treatment. If you have had symptoms of dyspareunia for months or years, and psychological factors play a role, you may need prolonged counseling before your symptoms are relieved.

Prevention

Although some causes of dyspareunia, such as a history of sexual abuse or trauma, can't be avoided, other causes can be prevented:

To decrease your risk of yeast infection, avoid tight clothing, wear cotton underpants and practice good hygiene. Change your underclothes after prolonged sweating. Bathe or shower daily, and change into dry clothing promptly after swimming.
To avoid bladder infections, wipe from front to back after using the toilet, and urinate after sexual intercourse.
To avoid sexually transmitted diseases, avoid sex or practice safe sex by maintaining a relationship with just one person, or using condoms to protect against sexually transmitted diseases.
To prevent vaginal dryness, use a lubricant, or seek treatment if the dryness is due to atrophic vaginitis.
If you have endometriosis, avoid very deep penetration, or have sex during the week or two after menstruation (before ovulation), when the condition tends to be less painful.
Treatment
Treatment depends on the cause of dyspareunia:

If vaginal dryness is the problem, you can ease penetration and sexual intercourse with increased clitoral stimulation before intercourse or lubrication with an over-the-counter lubricant such as K-Y jelly, Replens or Astroglide.
For vaginal yeast infections, you will be given antifungal medication.
Antibiotics will be prescribed for urinary tract infections or sexually transmitted diseases.
To relieve painful inflammation, try sitz baths, which are warm-water baths in a sitting position.
For skin diseases affecting the vaginal area, the treatment will vary depending on the disease. For example, lichen sclerosis and lichen planus often improve with steroid creams.
For vulvar vestibulitis, typical therapies include topical estrogen cream, low-dose pain medications, and physical therapy with biofeedback to lower the muscle tension in the pelvic floor.
For atrophic vaginitis, estrogen therapy will be prescribed, either as a vaginal formulation or as a pill.
If endometriosis is causing your dyspareunia, you may be prescribed medication or you may need surgical procedures to control or remove abnormal growths of uterine tissue.
For dyspareunia that has no apparent physical cause or has lasted for months or years, you may need psychological counseling to address stress or anxiety regarding sexual intercourse.


When To Call A Professional

Although sexual intercourse may be uncomfortable the very first time, it should never be painful. If you suddenly begin having pain before, during or after intercourse, see your doctor. It is important to seek care early, before you begin to avoid sexual intercourse or feel anxious in anticipation of your partner.

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Peter Mwaura M
Ariix Africa Team & Business Leader

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pmmutiti
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Peter Mwaura Mutiti : Teaching old blood cells new tricks:
When you hear someone mention circulation you probably think of the heart and major arteries—and for good reason. Circulatory disorders such as hypertension (high blood pressure) and atherosclerosis (hardening of the arteries) are major risk factors for heart disease, heart attacks, and stroke.

But there’s more to it than that. With all the attention on the heart and arteries, it’s easy to overlook serious health problems affecting the smallest components of the circulatory system—microscopic blood vessels called microcapillaries, where the critical exchange of oxygen and nutrients actually takes place. If blood isn’t flowing through this web properly, it can trigger all sorts of health problems, many of which may not seem related to circulation at all.

A number of factors contribute to poor circulation as we age. Arteries and veins become stiff and congested as cholesterol and calcium plaques accumulate and restrict blood flow. Spasms in the smooth muscles surrounding the circulatory arteries and veins can also choke off circulation. These same processes also occur in our microcapillaries, reducing microcirculation and impairing the critical exchange of nutrients and gases in tissues and major organs.

This problem only gets worse as we get older because of changes in the composition and structure of blood cells. As you reach middle age, the blood starts to thicken and congeal as platelets and blood proteins make cells sticky. Plus, the spleen—the organ that removes old, damaged blood cells from circulation—begins to slow down with age, which means new, healthy blood cells are replaced at a sharply reduced rate. And to make matters even worse, as blood cells age, they become stiff and no longer appear round and evenly shaped. This makes it harder for them to pass smoothly through the capillaries. In fact, the angular, jagged shape of the old cells can damage the fragile microcapillaries even further.

Eventually, these age-related changes take their toll on the microcapillaries, reducing circulation to the tissues and blocking the flow of nutrients and oxygen. Removal of carbon dioxide and other metabolic waste products is also hindered. This leads to a slow buildup of metabolic garbage that can gradually bury the cells in their own waste products. In time, the cells, poisoned by their own metabolic byproducts, begin to waste away and ultimately cease to function altogether.

The combined effect of poor circulation and old blood contributes to a host of symptoms, including deep fatigue, fuzzy thinking, frequent infections, and lowered sex drive—all conditions usually considered just “normal parts of aging.”

If circulation doesn’t improve, it can lead to more serious conditions, such as high blood pressure, heart attack, stroke, diabetes, and arthritis. But giving your body a fresh supply of healthy blood may target all of these problems and more.
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Registration date : 2008-01-10

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