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Psychiatry and Behavioral Health

Dyspareunia in Women

Educational Objective
To identify the key insights or developments described in this article

1 Credit CME

JAMA

Published Online: April 18, 2022

JAMA Insights

Article Information and Disclosures

Erin Gross, MD¹;

Linda Brubaker, MD^1,2

Author Affiliations

¹Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla
²Associate Editor, JAMA

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Dyspareunia (pain with intercourse) greatly affects the quality of life, libido, relationships, and self-image of the estimated 15% of women who have this condition.¹ This prevalence increases in postmenopausal women with vulvovaginal atrophy.² Dyspareunia prevalence, based on diagnostic coding, is likely underestimated because patients are often hesitant to discuss sexual pain with their clinician. Despite the preference of many patients to discuss these issues, clinicians may not initiate sexual health discussions because of a lack of time, lack of understanding about dyspareunia, or a perceived lack of importance.³ Clinicians can create a safe, confidential, professional encounter and initiate sexual health discussions with ubiquity statements such as “Many women may experience discomfort with sexual intimacy. Are there any sexual concerns you’d like to discuss?”

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Article Information

Corresponding Author: Erin Gross, MD, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, 9444 Medical Ctr Dr, La Jolla, CA 92093 (eagross@health.ucsd.edu).

Published Online: April 18, 2022. doi:10.1001/jama.2022.4853

Conflict of Interest Disclosures: Dr Brubaker reported receiving compensation from UpToDate and Female Pelvic Medicine & Reproductive Surgery and grants from the National Institutes of Health outside the submitted work. No other disclosures were reported.

References

Wheeler LJ , Guntupalli SR . Female sexual dysfunction: pharmacologic and therapeutic interventions. Obstet Gynecol. 2020;136(1):174-186. doi:10.1097/AOG.0000000000003941 PubMed Google Scholar Crossref

Shifren JL . Genitourinary syndrome of menopause. Clin Obstet Gynecol. 2018;61(3):508-516. doi:10.1097/GRF.0000000000000380 PubMed Google Scholar Crossref

Parish SJ , Hahn SR , Goldstein SW , et al. The International Society for the Study of Women’s Sexual Health process of care for the identification of sexual concerns and problems in women. Mayo Clin Proc. 2019;94(5):842-856. doi:10.1016/j.mayocp.2019.01.009 PubMed Google Scholar Crossref

Meister MR , Sutcliffe S , Ghetti C , et al. Development of a standardized, reproducible screening examination for assessment of pelvic floor myofascial pain. Am J Obstet Gynecol. 2019;220(3):255.e1-255.e9. doi:10.1016/j.ajog.2018.11.1106 PubMed Google Scholar Crossref

Burrows LJ , Goldstein AT . The treatment of vestibulodynia with topical estradiol and testosterone. Sex Med. 2013;1(1):30-33. doi:10.1002/sm2.4 PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 credit toward the CME of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.