Dyspareunia and vaginismus.

The understanding and treatment of vaginismus and dyspareunia have been greatly advanced by discoveries in sexual physiology and by the integration of the psychological sciences into clinical medicine. Historical evaluation of these problems should attend to their chronology, the impact on the individual and her relationships, and prior attempts at solution; and one should keep in mind common theories of etiology of sexual dysfunction. Physical examination, both as an educational instrument for the patient and as a means of localizing pain, can be most informative when undertaken with a thorough knowledge of the physiology of sexual response. Particular foci of dyspareunia may be amenable to various combinations of physical and psychological treatment.