Female Sexual Dysfunction in Women with Pelvic Pain

Abstract

A variety of conditions can give rise to the perception of painful sexual intercourse in women with pelvic pain. Female sexual dysfunction may stem from psychological, medical such as endocrinological disturbances, and gynecological pathologies. This article provides a discussion of various conditions, offering diagnostic and therapeutic measures to consider in women with pelvic pain experiencing sexual dysfunction. Treatment and management options are also reviewed.

Keywords

sexual dysfunction - pelvic pain - painful sex - female sexual dysfunction

• References

• 1 Shifren JL, Monz BU, Russo PA, Segreti A, Johannes CB. Sexual problems and distress in United States women: prevalence and correlates. Obstet Gynecol 2008; 112 (05) 970-978
• 2 Ghizzani A, Orlandini C, Bernardi MG, Cevenini G, Luisi S. Sexual pain in women: quality of sex life and marital relations. Minerva Ginecol 2017; 69 (04) 381-389
• 3 Boardman LA, Stockdale CK. Sexual pain. Clin Obstet Gynecol 2009; 52 (04) 682-690
• 4 Maciel M, Laganà L. Older women's sexual desire problems: biopsychosocial factors impacting them and barriers to their clinical assessment. BioMed Res Int 2014; 2014: 107217
• 5 Elmerstig E, Wijma B, Berterö C. Why do young women continue to have sexual intercourse despite pain?. J Adolesc Health 2008; 43 (04) 357-363
• 6 Abdulcadir J, Bianchi Demicheli F, Willame A, Recordon N, Petignat P. Post-traumatic stress disorder relapse and clitoral reconstruction after female genital mutilation. Obstet Gynecol 2017; 129 (02) 371-376
• 7 Wright JJ, O'Connor KM. Female sexual dysfunction. Med Clin North Am 2015; 99 (03) 607-628
• 8 Mac Bride MB, Rhodes DJ, Shuster LT. Vulvovaginal atrophy. Mayo Clin Proc 2010; 85 (01) 87-94
• 9 Portman DJ, Gass MLS. ; Vulvovaginal Atrophy Terminology Consensus Conference Panel. Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women's Sexual Health and the North American Menopause Society. J Sex Med 2014; 11 (12) 2865-2872
• 10 Ottem DP, Carr LK, Perks AE, Lee P, Teichman JMH. Interstitial cystitis and female sexual dysfunction. Urology 2007; 69 (04) 608-610
• 11 Bogart LM, Suttorp MJ, Elliott MN, Clemens JQ, Berry SH. Prevalence and correlates of sexual dysfunction among women with bladder pain syndrome/interstitial cystitis. Urology 2011; 77 (03) 576-580
• 12 Liu B, Su M, Zhan H, Yang F, Li W, Zhou X. Adding a sexual dysfunction domain to UPOINT system improves association with symptoms in women with interstitial cystitis and bladder pain syndrome. Urology 2014; 84 (06) 1308-1313
• 13 Jia SZ, Leng JH, Sun PR, Lang JH. Prevalence and associated factors of female sexual dysfunction in women with endometriosis. Obstet Gynecol 2013; 121 (03) 601-606
• 14 Fauconnier A, Chapron C, Dubuisson JB, Vieira M, Dousset B, Bréart G. Relation between pain symptoms and the anatomic location of deep infiltrating endometriosis. Fertil Steril 2002; 78 (04) 719-726
• 15 Fritzer N, Haas D, Oppelt P. , et al. More than just bad sex: sexual dysfunction and distress in patients with endometriosis. Eur J Obstet Gynecol Reprod Biol 2013; 169 (02) 392-396
• 16 Månsson M, Norström K, Holte J, Landin-Wilhelmsen K, Dahlgren E, Landén M. Sexuality and psychological wellbeing in women with polycystic ovary syndrome compared with healthy controls. Eur J Obstet Gynecol Reprod Biol 2011; 155 (02) 161-165
• 17 Song T, Choi CH, Lee YY. , et al. Sexual function after surgery for early-stage cervical cancer: is there a difference in it according to the extent of surgical radicality?. J Sex Med 2012; 9 (06) 1697-1704
• 18 Bergmark K, Avall-Lundqvist E, Dickman PW, Henningsohn L, Steineck G. Vaginal changes and sexuality in women with a history of cervical cancer. N Engl J Med 1999; 340 (18) 1383-1389
• 19 Amarenco G, Kerdraon J, Albert T, Denys P. [Stretch neuropathy of the internal pudendal nerve. Its relationship to urinary incontinence, anorectal, and genito-sexual disorders in women]. Contracept Fertil Sex 1994; 22 (04) 235-238
• 20 Handa VL, Cundiff G, Chang HH, Helzlsouer KJ. Female sexual function and pelvic floor disorders. Obstet Gynecol 2008; 111 (05) 1045-1052
• 21 Lahaie MA, Amsel R, Khalifé S, Boyer S, Faaborg-Andersen M, Binik YM. Can fear, pain and muscle tension discriminate vaginismus from dyspareunia/provoked vestibulodynia? Implications for the new DSM-5 of genito-pelvic pain/penetration disorder. Arch Sex Behav 2015; 44 (06) 1537-1550
• 22 Simonelli C, Eleuteri S, Petruccelli F, Rossi R. Female sexual pain disorders: dyspareunia and vaginismus. Curr Opin Psychiatry 2014; 27 (06) 406-412
• 23 Bonham A. Vulvar vestibulodynia: strategies to meet the challenge. Obstet Gynecol Surv 2015; 70 (04) 274-278
• 24 Swanson CL, Rueter JA, Olson JE, Weaver AL, Stanhope CR. Localized provoked vestibulodynia: outcomes after modified vestibulectomy. J Reprod Med 2014; 59 (3-4): 121-126
• 25 Bornstein J, Goldstein AT, Stockdale CK. , et al; consensus vulvar pain terminology committee of the International Society for the Study of Vulvovaginal Disease (ISSVD); International Society for the Study of Women's Sexual Health (ISSWSH); International Pelvic Pain Society (IPPS). 2015 ISSVD ISSWSH, and IPPS consensus terminology and classification of persistent vulvar pain and vulvodynia. J Sex Med 2016; 13 (04) 607-612
• 26 Prendergast SA. Pelvic floor physical therapy for vulvodynia: a clinician's guide. Obstet Gynecol Clin North Am 2017; 44 (03) 509-522
• 27 Kliethermes CJ, Shah M, Hoffstetter S, Gavard JA, Steele A. Effect of vestibulectomy for intractable vulvodynia. J Minim Invasive Gynecol 2016; 23 (07) 1152-1157
• 28 Andrews JC. Vulvodynia interventions--systematic review and evidence grading. Obstet Gynecol Surv 2011; 66 (05) 299-315
• 29 Goldstein AT, Pukall CF, Brown C, Bergeron S, Stein A, Kellogg-Spadt S. Vulvodynia: assessment and treatment. J Sex Med 2016; 13 (04) 572-590
• 30 Gray TG, Alexander C, Jones GL, Tidy JA, Palmer JE, Radley SC. Development and psychometric testing of an electronic patient-reported outcome tool for vulval disorders (ePAQ-Vulva). J Low Genit Tract Dis 2017; 21 (04) 319-326
• 31 Woodruff JD, Friedrich Jr EG. The vestibule. Clin Obstet Gynecol 1985; 28 (01) 134-141
• 32 Brown CS, Bachmann GA, Wan J, Foster DC. ; Gabapentin (GABA) Study Group. Gabapentin for the treatment of vulvodynia: a randomized control trial. Obstet Gynecol 2018; 131 (06) 1000-1007
• 33 Reed BD, Harlow SD, Sen A. , et al. Prevalence and demographic characteristics of vulvodynia in a population-based sample. Am J Obstet Gynecol 2012; 206 (02) 170.e1-170.e9
• 34 Pluchino N, Wenger JM, Petignat P. , et al. Sexual function in endometriosis patients and their partners: effect of the disease and consequences of treatment. Hum Reprod Update 2016; 22 (06) 762-774
• 35 Lukic A, Di Properzio M, De Carlo S. , et al. Quality of sex life in endometriosis patients with deep dyspareunia before and after laparoscopic treatment. Arch Gynecol Obstet 2016; 293 (03) 583-590
• 36 Prairie BA, Wisniewski SR, Luther J. , et al. Symptoms of depressed mood, disturbed sleep, and sexual problems in midlife women: cross-sectional data from the study of women's health across the nation. J Womens Health (Larchmt) 2015; 24 (02) 119-126
• 37 Kling JM, Manson JE, Naughton MJ. , et al. Association of sleep disturbance and sexual function in postmenopausal women. Menopause 2017; 24 (06) 604-612
• 38 Bassaly R, Downes K, Hart S. Dietary consumption triggers in interstitial cystitis/bladder pain syndrome patients. Female Pelvic Med Reconstr Surg 2011; 17 (01) 36-39
• 39 Friedlander JI, Shorter B, Moldwin RM. Diet and its role in interstitial cystitis/bladder pain syndrome (IC/BPS) and comorbid conditions. BJU Int 2012; 109 (11) 1584-1591
• 40 Berghmans B. Physiotherapy for pelvic pain and female sexual dysfunction: an untapped resource. Int Urogynecol J Pelvic Floor Dysfunct 2018; 29 (05) 631-638
• 41 Constantine G, Graham S, Portman DJ, Rosen RC, Kingsberg SA. Female sexual function improved with ospemifene in postmenopausal women with vulvar and vaginal atrophy: results of a randomized, placebo-controlled trial. Climacteric 2015; 18 (02) 226-232
• 42 Wurz GT, Kao CJ, DeGregorio MW. Safety and efficacy of ospemifene for the treatment of dyspareunia associated with vulvar and vaginal atrophy due to menopause. Clin Interv Aging 2014; 9: 1939-1950
• 43 Derogatis LR, Komer L, Katz M. , et al; VIOLET Trial Investigators. Treatment of hypoactive sexual desire disorder in premenopausal women: efficacy of flibanserin in the VIOLET Study. J Sex Med 2012; 9 (04) 1074-1085
• 44 Joffe HV, Chang C, Sewell C. , et al. FDA approval of flibanserin--treating hypoactive sexual desire disorder. N Engl J Med 2016; 374 (02) 101-104
• 45 Annon JS. The PLISSIT model: a proposed conceptual scheme for the behavioral treatment of sexual problems. J Sex Educ Ther 1976; 2: 1-15
• 46 Althof SE, Leiblum SR, Chevret-Measson M. , et al. Psychological and interpersonal dimensions of sexual function and dysfunction. J Sex Med 2005; 2 (06) 793-800
• 47 Kingsberg SA, Althof S, Simon JA. , et al. Female sexual dysfunction-medical and psychological treatments, Committee 14. J Sex Med 2017; 14 (12) 1463-1491
• 48 Frühauf S, Gerger H, Schmidt HM, Munder T, Barth J. Efficacy of psychological interventions for sexual dysfunction: a systematic review and meta-analysis. Arch Sex Behav 2013; 42 (06) 915-933