Dyspareunia pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
Overview
pathophysiology of genito-pelvic pain/ penetration disorder(GPPPD) can be considered as multifactorial, multisystemic, or complex.
Pathophysiology
Pathophysiology of sexual pain disorders in female can be considered as:[1][2]
- Multifactorial
- Multisystemic
- Complex
Multifactorial:
- Biological, psychosexual, relational factors can coexist and interact to perpetuate and maintain a woman’s pain response in a woman complaining of coital pain. Over time, these different factors may act as predisposing, precipitating, or perpetuating sexual pain disorders.
Multisystemic: sexual function involves:
- Nervous system
- Endocrine system
- Vascular system
- Immunological systems
- Vaginal ecosystem: Vaginal receptiveness may be further modulated by; psychosexual, mental, interpersonal factors that may result in poor arousal with vaginal dryness. Fear of penetration, general muscular arousal secondary to anxiety, defensive contraction of the peri-vaginal muscles, leading to lifelong vaginismus.
Complex:Coital pain is greater than the simple peripheral tissue damage that may initially trigger the nociceptive component. When It becomes chronic, the pathophysiology of pain may gradually shift from nociceptive, a friend signal that should induce self-protection and defense, to neuropathic, with progressive involvement of the CNS.[3]
- If pain is due to a physical cause, the pathophysiology of the underlying cause should be considered.
The pathophysiology of dyspareunia in males depends on the underlying cause, psychosexual and relational factors.