Dyspareunia classification

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

Dyspareunia may be classified into different types based on its location, onset, and frequency in women. Male dyspareunia is divided into broad categories of underlying causes ranging from anatomic anomalies to psychosocial problems.

• Based on Diagnosis Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013),dyspareunia and vaginismus were typically classified as distinct sexual pain disorders. This new classification unifies vaginismus and dyspareunia into one category called “genito-pelvic pain/penetration disorder” due to the clinical difficulties in distinguishing these conditions because, in practice, it is difficult to differentiate these two from each other. Sometimes the pain may cause pelvic muscle spasms or involuntary pelvic muscle spasms in vaginismus to cause pain. GPPPD is an umbrella term for two sexual pain disorders:dyspareunia and vaginismus. However, possible medical causes of dyspareunia should be ruled out or treated before considering a diagnosis of Genito-Pelvic Pain/Penetration Disorder (GPPPD). If a medical cause is successfully treated and pain has not been resolved yet, a diagnosis of vulvodynia or genito-pelvic/penetration disorder is appropriate.^[1]

Dyspareunia may be classified into 2 type: superficial and deep based on its location:

• Superficial, which occurs in or around the vaginal entrance, and is characterized by initial discomfort in initial or attempted penetration of the vaginal introitus. Commonly found in:
• Deep dyspareunia is a pain that occurs with deep vaginal penetration, which results from pelvic thrusting during intercourse. Conditions are associated with deep dyspareunia are:
  • Chronic pelvic pain
  • Endometriosis
  • Chronic PID

It may be classified into 2 type: primary and secondary based on its onset:

• Primary (onset with first sexual experience) Often has psychological causes, such as sexual abuse in childhood, feeling of guilt or shame toward sex or fear of intercourse or painful first intercourse.
• Secondary dyspareunia that its beginning is after a previous sexual activity that was not painful.
  

Dyspareunia can be classified into 2 types: persistent or conditional, based on its frequency:

• Persistent which occurs in all situations, possibly due to physical or psychological factors.
• Conditional dyspareunia that occurs in certain situations.Abdomino-pelvic disorders such as endometriosis, imperforate hymen, vaginal septum, or organic vulvodynia due to infection, lichen sclerosis, or vestibulitis, vaginal infections, prolapse, trauma, or vaginal dryness can cause dyspareunia. It can also be due to gastrointestinal disorders such as chronic constipation, diverticular diseases, inflammatory bowel disease/proctitis. Scarring due to previous pelvic surgery, episiotomy, and perineorraphy, or urological causes such as cystitis, interstitial cystitis, or urethritis can cause dyspareunia as well. Male dyspareunia is divided into broad categories of underlying causes ranging from anatomic anomalies to psychosocial problems. Male dyspareunia is related to the following anatomical structures: 1) prepuce, 2) glans penis, 3) penile shaft, 4) testicles, and 5) urethra and prostate gland. Another classification system defines four broad categories: Isolated painful ejaculation, Chronic prostatitis/chronic pelvic pain, Medical causes, psychological causes.

Male dyspareunia may be classified into broad categories. It may be classified into 5 subtypes based on anatomic anomalies:
(1) prepuce
(2) glans penis
(3) penile shaft
(4) testicles
(5) urethra and prostate gland
Another classification system defines four broad categories for male dyspareunia:

• Isolated painful ejaculation
• Chronic prostatitis/chronic pelvic pain
• Medical causes
• psychological causes.