DYSPAREUNIA

painful or difficult sexual intercourse in the female. Disorders are generally physical rather than psychological. Dyspareunia may be caused by inflammation or infection of the vagina, vaginismus (q.v.; voluntary or involuntary contraction of the lower vaginal muscles), remnants of the hymen, insufficient lubrication of the vagina, infection, endometriosis, tumours, or other pathologic conditions (including those of the anussuch as hemorrhoidsor in the urinary tract). It may also be partially or (rarely) fully the result of psychosexual conflicts; for example, pain experienced in the first few attempts at sexual intercourse may lead to aversion to it and fear even after the pain is no longer encountered. Diagnosis of the underlying cause of dyspareunia may indicate treatment for infection or inflammation, sexual counseling and education on anatomy and sexual functioning, the use of lubricants, and, in some instances, surgical removal of tumours or treatment of endometriosis. The cooperation of both partners in treatment is usually desirable.