Deep dyspareunia; Multidisciplinary approach; Superficial dyspareunia
Abstract :
[en] Dyspareunia is defined as pain during sexual intercourse. It will be qualified as superficial if it occurs during the vaginal penetration and as deep when it appears in the lower abdomen or further in the vagina. It concerns between 10 and 28 % of women during their lifetime and will have a significant impact on their quality of life. Multidisciplinary care will allow an accurate diagnosis and optimal treatment. The collaboration between general practitioner, gynecologist, physiotherapist and psychologist is mandatory in order to improve the quality of life of patients. [fr] La dyspareunie se définit par une douleur lors du rapport sexuel. Elle sera qualifiée de superficielle si elle survient lors de la pénétration du vagin, et de profonde lorsqu’elle apparaît lors de la pénétration complète et est décrite dans le bas du ventre ou dans le fond du vagin. Elle concerne entre 10 et 28 % des femmes au cours de leur vie et impactera de manière importante leur qualité de vie. Une prise en charge multidisciplinaire permettra un diagnostic précis et un traitement optimal. La collaboration entre médecin traitant, gynécologue, physiothérapeute et psychologue est une condition sine qua non pour l’amélioration de la qualité de vie des patientes.
Disciplines :
Reproductive medicine (gynecology, andrology, obstetrics)
Author, co-author :
Brichant, Géraldine ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique (CHR) ; Service de Gynécologie-Obstétrique, CHULiège, Citadelle, Liège, Belgique
CARVELLI, Pierre ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique (CHR) ; Service de Gynécologie-Obstétrique, CHULiège, Citadelle, Liège, Belgique
Moise, Alice ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique (CHR) ; Service de Gynécologie-Obstétrique, CHULiège, Citadelle, Liège, Belgique
Nisolle, Michelle ; Université de Liège - ULiège > Département des sciences cliniques > Gynécologie - Obstétrique ; Service de Gynécologie-Obstétrique, CHULiège, Citadelle, Liège, Belgique
Panariello, Béatrice ; Université de Liège - ULiège > Département des sciences de la vie > Ethologie et psychologie animales (succ. J.-Cl. Ruwet) ; Service de Psychologie clinique, CHR Citadelle, Liège, Belgique
ROUSSEAU, Laetitia ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique (CHR) ; Service de Gynécologie-Obstétrique, CHULiège, Citadelle, Liège, Belgique
Language :
French
Title :
La dyspareunie féminine, pas un simple trouble fonctionnel !
Alternative titles :
[en] La dyspareunie féminine, not a simple functional disorder !.
Harlow BL, Kunitz CG, Nguyen RH,et al. Prevalence of symptoms consistent with a diagnosis of vulvodynia: population-based estimates from 2 geographic regions. Am J Obstet Gynecol 2014;210:40.e1-8.
Fritzer N, Tammaa A, Haas D, et al. When sex is not on fire: a prospective multicentre study evaluating the short-term effects of radical resection of endometriosis on quality of sex life and dyspareunia. Eur J Obstet Gynecol Reprod Biol 2016;197:36-40.
Bois E, Clément C, Graesslin O. Vulvodynies essentielles. EMC 2011. p. 162-A-20.Disponible sur https://www.em-consulte.com/article/409659/vulvodynies-essentielles
Moyal-Barracco M, Lynch PJ. 2003 ISSVD terminology and classification of vulvodynia: a historical perspective. J Reprod Med 2004;49:772-7.
Bautrant E. Vulvodynies. EMC Gynécologie 2022. p. 1-9. Disponible sur: https://www.em-consulte.com/article/1528962/vulvodynies
Harlow BL, Stewart EG. A population-based assessment of chronic unexplained vulvar pain: have we underestimated the prevalence of vulvodynia? J Am Med Womens Assoc (1972) 2003;58:82-8.
Regauer S, Eberz B, Beham-Schmid C. Mast cell infiltrates in vulvodynia represent secondary and idiopathic mast cell hyperplasias. APMIS 2015;123:452-6.
Labat JJ, Riant T, Robert R, et al. Diagnostic criteria for pudendal neuralgia by pudendal nerve entrapment (Nantes criteria). Neurourol Urodyn 2008;27:306-10.
Giamberardino MA, Affaitati G, Fabrizio A, Costantini R. Myofascial pain syndromes and their evaluation. Best Pract Res Clin Rheumatol 2011;25:185-98.
Bautrant E, Porta O, Murina F, et al. Provoked vulvar vestibulodynia: epidemiology in Europe, physio-pathology, consensus for first-line treatment and evaluation of second-line treatments. J Gynecol Obstet Hum Reprod 2019;48:685-8.
Leeman LM, Rogers RG. Sex after childbirth: postpartum sexual function. Obstet Gynecol 2012;119:647-55.
Woodward AP, Matthews CA. Outcomes of revision perineoplasty for persistent postpartum dyspareunia. Female Pelvic Med Reconstr Surg 2010;16:135-9.
OMS (Organisation Mondiale de la Santé). Mutilations sexuelles féminines 2023 [Available from: https://www.who.int/fr/news-room/fact-sheets/detail/female-genital-mutilation. Dernière consultation le 02/02/2023.
Morgan J. Working towards an end to FGM. Lancet 2015;385:843-4.
Dirie MA, Lindmark G. The risk of medical complications after female circumcision. East Afr Med J 1992;69:479-82.
Swenen L, Brichant G, Kaluanga A,et al. Les mutilations génitales féminines: le point sur la situation au Centre Hospitalier Régional de la Citadelle. Rev Med Liege 2017;72:25-31.
Foldes P, Cuzin B, Andro A. Reconstructive surgery after female genital mutilation: a prospective cohort study. Lancet 2012;380:134-41.
Abdulcadir J, Bianchi-Demicheli F, Petignat P. Fonction sexuelle et reconstruction du clitoris après mutilation génitale féminine. Rev Med Suisse 2017;13:597-601.
Nisolle M, Alvarez ML, Colombo M, Foidart JM. L’endométriose: de la recherche à la pratique clinique. Bull Mem Acad R Med Belg 2007;162:263-72; discussion 73-4.
Malekmaleki S, Shahali S, Moini A. Sexual self-efficacy and sexual quality of life before and after laparoscopic surgery in women with endometriosis lesions: a cross-sectional study. Int J Reprod Biomed 2022;20:469-76.
Gandhi J, Chen A, Dagur G, et al. Genitourinary syndrome of menopause: an overview of clinical manifestations, pathophysiology, etiology, evaluation, and management. Am J Obstet Gynecol 2016;215:704-11.
Matthes Â. Current commentaries about deep dyspareunia and the genito-urinary syndrome of menopause. MOJ Women’s health 2017;5.225-7.
Siedhoff MT, Carey ET, Findley AD, et al. Post-hysterectomy dyspareunia. J Minim Invasive Gynecol 2014;21:567-75.
Antosh DD, Gutman RE, Park AJ, et al. Vaginal dilators for prevention of dyspareunia after prolapse surgery: a randomized controlled trial. Obstet Gynecol 2013;121:1273-80.
Stinesen Kollberg K, Waldenstrom AC, Bergmark K, et al. Reduced vaginal elasticity, reduced lubrication, and deep and superficial dyspareunia in irradiated gynecological cancer survivors. Acta Oncol 2015;54:772-9.
Fernando RJ, Thakar R, Sultan AH, et al. Effect of vaginal pessaries on symptoms associated with pelvic organ prolapse. Obstet Gynecol 2006;108:93-9.
Soysal ME, Soysal S, Vicdan K, Ozer S. A randomized controlled trial of goserelin and medroxyprogesterone acetate in the treatment of pelvic congestion. Hum Reprod 2001;16:931-9.
Vercellini P, Daguati R, Abbiati A. Chronic Pelvic Pain. In Arici A, Seli E, editors. Non-invasive management of gynecologic disorders. 1st ed. London;CRC Press:2008. p. 33-51.
Moshesh M, Olshan AF, Saldana T, Baird D. Examining the relationship between uterine fibroids and dyspareunia among premenopausal women in the United States. J Sex Med 2014;11:800-8.
Till SR, Hobbs KA, Moulder JK, et al. Change in sexual function at one year among women undergoing hysterectomy for pain-related verses non-pain indications. J Minim Invasive Gynecol 2015;22:S16.
Ertunc D, Uzun R, Tok EC, et al. The effect of myoma uteri and myomectomy on sexual function. J Sex Med 2009;6:1032-8.
Jacoby VL, Jacoby A, Learman LA, et al. Use of medical, surgical and complementary treatments among women with fibroids. Eur J Obstet Gynecol Reprod Biol 2014;182:220-5.
Fauconnier A, Dubuisson JB, Foulot H, et al. Mobile uterine retro-version is associated with dyspareunia and dysmenorrhea in an unselected population of women. Eur J Obstet Gynecol Reprod Biol 2006;127:252-6.
Ott J, Nouri K, Demmel M, et al. Fourteen-year experience with laparoscopic ventrosuspension in patients with retroverted and retroflected uterus and pelvic pain syndromes. J Minim Invasive Gynecol 2010;17:749-53.
Hanno PM, Burks DA, Clemens JQ, et al. AUA guideline for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome. J Urol 2011;185:2162-70.
Lovell RM, Ford AC. Effect of gender on prevalence of irritable bowel syndrome in the community: systematic review and meta-analysis. Am J Gastroenterol 2012;107:991-1000.
Orr NL, Noga H, Williams C, et al. Deep dyspareunia in endometriosis: role of the bladder and pelvic floor. J Sex Med 2018;15:1158-66.
Reed BD, Sen A, Harlow SD, et al. Multimodal vulvar and peripheral sensitivity among women with vulvodynia: a case-control study. J Low Genit Tract Dis 2017;21:78-84.
Whitmore K, Siegel JF, Kellogg-Spadt S. Interstitial cystitis/painful bladder syndrome as a cause of sexual pain in women: a diagnosis to consider. J Sex Med 2007;4:720-7.
Germain B, Langis P. Réponse sexuelle. Dans: La sexualité humaine. 1ère éd. Parisl: Éditions du Renouveau Pédagogique Inc: 2009. p. 69-97.
American Psychiatric Association(AP). DSM-5®: Manuel diagnostique et statistique des troubles mentaux. 5ème édition. Issy les Moulineaux;Elservier Masson SAS:2015.
Hubin A, De Sutter P, Reynaert C. Les facteurs étiologiques du désir sexuel hypoactif féminin. Sexologies 2011;20:178-87.
Merlino L, Titi L, Pugliese F, et al. Vulvodynia: pain management strategies. Pharmaceuticals (Basel) 2022;15:1514.
Jarousse N, Beaudry M, Boisvert J-M. Stratégies thérapeutiques face aux conséquences sexuelles et conjugales des victimes d’aggression sexuelle. Dans Poudat FX éditeur. Sexualité, couple et TCC Volume 2: les difficultés conjugales. Issy les Moulineaux;Elsevier Masson:2011. p131-44.
De Sutter P. La sexualité des gens heureux. 1ère éd. Paris; Les Arènes:2009.
Germain B, Langis P. Amour, couple et communication intime. Dans La sexualité humaine. 1ère édition. Paris; Editions du Renouveau Pédagogique Inc:2009. p312-30.