Should dyspareunia be retained as a sexual dysfunction in DSM-V? A painful classification decision.

The DSM-IV-TR (American Psychiatric Association, 2000) classifies dyspareunia as a sexual dysfunction and describes it as a "sexual pain" disorder. This classification has been widely accepted with little controversy despite the absence of a theoretical rationale or supporting empirical data. An examination of the validity of this classification suggests that there is little current justification for the use of the term "sexual pain" or for considering dyspareunia a sexual dysfunction. Dyspareunia fits the current DSM-IV-TR classification criteria for pain disorder better than it fits those for sexual dysfunction. Empirical data from diagnostic, experimental, and therapy outcome studies support this conclusion. The reconceptualization of dyspareunia as a pain disorder rather than as a sexual dysfunction has important implications for the understanding and treatment of this prevalent but neglected women's health problem.