Awareness of Evidence-Based Treatments Among Women with Dyspareunia: A Cross-Sectional Survey Study.

Background

Dyspareunia is a common female sexual pain disorder that significantly impairs quality of life. Despite the availability of evidence-based treatments, including multimodal pelvic floor physiotherapy and psychosexual interventions, patient awareness of these options remains insufficiently characterized. This study aimed to assess knowledge of dyspareunia management among affected women and to identify independent predictors of awareness.

Methods

A cross-sectional survey was conducted in 2023 at the Central Clinical Hospital of the Medical University of Lodz, Poland, among 72 women with physician-confirmed dyspareunia. An 82-item questionnaire administered via structured face-to-face interviews assessed sociodemographic characteristics, clinical features including intercourse positions, penetration depth, and partner-related factors, and knowledge of pelvic floor therapy. Responses to 18 knowledge items were aggregated into a synthetic awareness variable (range 0-24 points). Internal consistency was evaluated using Cronbach's alpha. Statistical analysis included item-level scoring, multiple linear regression, Mann-Whitney U test, Kruskal-Wallis test, and Spearman's rank correlation. Effect sizes are reported as Cohen's d for parametric comparisons and rank-biserial correlation for nonparametric comparisons.

Results

The mean awareness score was 10.9 ± 6.1 out of 24 points. The awareness scale demonstrated good internal consistency (standardized Cronbach's α = 0.880). Item-level analysis revealed critical knowledge gaps: biofeedback was recognized by only 15.3% of participants, and only 6.2% could correctly estimate the number of pelvic floor muscles. In multiple linear regression (R2 = 0.224, adjusted R2 = 0.153, p = 0.009), age (β = -0.305, p = 0.009) and current urogynecological physiotherapy use (β = 0.332, p = 0.019) were independent predictors of awareness. Physiotherapy users scored on average 5.6 points higher than non-users (16.0 ± 4.9 vs. 10.4 ± 6.0; p = 0.027; rank-biserial r = 0.51), although this finding should be interpreted with caution given the small number of physiotherapy users (n = 7) and the wide confidence interval. More than half of participants (55.6%) reported positional dependency of dyspareunia; in exploratory analyses, none of the assessed dyspareunia characteristics showed a statistically significant association with awareness. Younger women (≤24 years) demonstrated significantly higher awareness than older participants (12.1 ± 5.6 vs. 9.1 ± 6.5; p = 0.039; Cohen's d = 0.51).

Conclusions

Women with dyspareunia demonstrate modest and heterogeneous awareness of evidence-based treatments, with the largest deficits in knowledge of specific physiotherapeutic modalities. These findings highlight the need for targeted educational interventions and improved referral pathways to pelvic floor physiotherapy. This study establishes a conceptual framework for assessing patient awareness of dyspareunia treatments, which warrants validation in larger, multi-center studies.