{"paper_id":"3f3e3ee5-287c-41df-8a8d-c1593973454a","body_text":"- Library Home /\n- Search Collections /\n- Open Collections /\n- Browse Collections /\n- UBC Faculty Research and Publications /\n- Deep Dyspareunia : Review of Pathophysiology and Proposed...\nOpen Collections\nUBC Faculty Research and Publications\nDeep Dyspareunia : Review of Pathophysiology and Proposed Future Research Priorities Orr, Natasha L.; Wahl, Kate; Joannou, Angela; Hartmann, Dee; Valle, Lisa; Yong, Paul J.; International Society for the Study of Women’s Sexual Health. Special Interest Group on Sexual Pain\nAbstract\nIntroduction: Dyspareunia has been traditionally divided into superficial (introital) dyspareunia and deep dyspareunia (pain with deep penetration). While deep dyspareunia can co-exist with a variety of conditions, recent work in endometriosis has demonstrated that co-existence does not necessarily imply causation. Therefore, a re-consideration of the literature is required to clarify the pathophysiology of deep dyspareunia.\nAims: To review the pathophysiology of deep dyspareunia, and to propose future research priorities.\nMethods: Narrative review after appraisal of published frameworks and literature search with the terms (dyspareunia AND endometriosis), (dyspareunia AND deep), (dyspareunia AND (pathophysiology OR etiology)).\nMain Outcome Variable: Deep dyspareunia (present/absent or along a pain severity scale).\nResults: Potential etiologies for deep dyspareunia include gynecological, urological, gastrointestinal, nervous system, psychological, and musculoskeletal system related. These etiologies can be classified according to anatomic mechanism (contact with a tender pouch of Douglas, uterus-cervix, bladder, or pelvic floor, with deep penetration). They can also be stratified into four categories (as previously proposed for endometriosis specifically), which can be utilized to personalize management: Type I (primarily gynecologic), Type II (non-gynecologic comorbid conditions), Type III (central sensitization and genito-pelvic pain\npenetration disorder), and Type IV (mixed). Sociocultural and genetic factors and sexual response may also be important for deep dyspareunia.\nConclusion: We propose the following eight research priorities for deep dyspareunia: 1) development of deep dyspareunia measurement tools; 2) focus on the population who are avoiding intercourse due to deep dyspareunia; 3) clarification of the role of non-gynecologic comorbidities in the generation of deep dyspareunia; 4) addressing of ethnic and other sociocultural factors; 5) initiation of clinical trials with adequate power for deep dyspareunia outcomes; 6) inclusion of partner variables; 7) elucidation of pathways between psychological factors and deep dyspareunia; and 8) empirical validation of personalized approaches to deep dyspareunia.\nItem Metadata\n| Title |\nDeep Dyspareunia : Review of Pathophysiology and Proposed Future Research Priorities\n|\n| Creator | |\n| Contributor | |\n| Date Issued |\n2018-10-16\n|\n| Description |\nIntroduction: Dyspareunia has been traditionally divided into superficial (introital) dyspareunia and deep dyspareunia (pain with deep penetration). While deep dyspareunia can co-exist with a variety of conditions, recent work in endometriosis has demonstrated that co-existence does not necessarily imply causation. Therefore, a re-consideration of the literature is required to clarify the pathophysiology of deep dyspareunia.\nAims: To review the pathophysiology of deep dyspareunia, and to propose future research priorities.\nMethods: Narrative review after appraisal of published frameworks and literature search with the terms (dyspareunia AND endometriosis), (dyspareunia AND deep), (dyspareunia AND (pathophysiology OR etiology)).\nMain Outcome Variable: Deep dyspareunia (present/absent or along a pain severity scale).\nResults: Potential etiologies for deep dyspareunia include gynecological, urological, gastrointestinal, nervous system, psychological, and musculoskeletal system related. These etiologies can be classified according to anatomic mechanism (contact with a tender pouch of Douglas, uterus-cervix, bladder, or pelvic floor, with deep penetration). They can also be stratified into four categories (as previously proposed for endometriosis specifically), which can be utilized to personalize management: Type I (primarily gynecologic), Type II (non-gynecologic comorbid conditions), Type III (central sensitization and genito-pelvic pain\npenetration disorder), and Type IV (mixed). Sociocultural and genetic factors and sexual response may also be important for deep dyspareunia.\nConclusion: We propose the following eight research priorities for deep dyspareunia: 1) development of deep dyspareunia measurement tools; 2) focus on the population who are avoiding intercourse due to deep dyspareunia; 3) clarification of the role of non-gynecologic comorbidities in the generation of deep dyspareunia; 4) addressing of ethnic and other sociocultural factors; 5) initiation of clinical trials with adequate power for deep dyspareunia outcomes; 6) inclusion of partner variables; 7) elucidation of pathways between psychological factors and deep dyspareunia; and 8) empirical validation of personalized approaches to deep dyspareunia.\n|\n| Subject | |\n| Genre | |\n| Type | |\n| Language |\neng\n|\n| Date Available |\n2019-07-23\n|\n| Provider |\nVancouver : University of British Columbia Library\n|\n| Rights |\nAttribution-NonCommercial-NoDerivatives 4.0 International\n|\n| DOI |\n10.14288/1.0379943\n|\n| URI | |\n| Affiliation | |\n| Publisher DOI |\n10.1016/j.sxmr.2018.12.007\n|\n| Peer Review Status |\nUnreviewed\n|\n| Scholarly Level |\nFaculty; Graduate; Undergraduate\n|\n| Rights URI | |\n| Aggregated Source Repository |\nDSpace\n|\nItem Media\nItem Citations and Data\nRights\nAttribution-NonCommercial-NoDerivatives 4.0 International","source_license":"CC0","license_restricted":false}