Causes and treatment options for women with dyspareunia.

The incidence of dyspareunia, defined as difficult and painful intercourse, appears to be increasing. A symptom not a disease, dyspareunia is rarely reported by patients, even though it may be the actual reason why they seek health care. Often, patients will only discuss their concerns after questioning. Health care professionals who provide primary care to women must understand the various etiologies of dyspareunia. Possible causes of dyspareunia as well as current treatment modalities are identified. Sex education, counseling, vaginal dilatation and pelvic-relaxation exercises may be needed to restore the woman's confidence and decrease anxiety. Not until all organic causes of dyspareunia are ruled out, should the option of psychiatric intervention be suggested.