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Deep dyspareunia: causes, treatments, and results

Ferrero, Simone; Ragni, Nicola; Remorgida, Valentino

Current Opinion in Obstetrics and Gynecology: August 2008 - Volume 20 - Issue 4 - p 394–399
doi: 10.1097/GCO.0b013e328305b9ca
Reproductive endocrinology: Edited by David L. Olive

Purpose of review We critically review the causes and treatments of deep dyspareunia.

Recent findings Endometriosis, pelvic congestion syndrome, and interstitial cystitis have been associated with deep dyspareunia. Although medical therapies may improve deep dyspareunia in women with endometriosis, laparoscopic excision of deep endometriotic lesions has been demonstrated to improve not only deep dyspareunia but also the quality of sex life. Deep dyspareunia related to the presence of pelvic congestion syndrome should be treated by pelvic vein embolization. Intravesical therapy may be effective in treating deep dyspareunia in women with interstitial cystitis. It remains unclear whether uterine myomas and adenomyosis are causes of deep dyspareunia.

Summary Treatment of deep dyspareunia should be mainly directed to causative factors; however, clinicians should keep in mind that secondary sexual dysfunction can arise from organic pelvic pathology.

Department of Obstetrics and Gynaecology, San Martino Hospital and University of Genoa, Genova, Italy

Correspondence to Simone Ferrero, MD, Department of Obstetrics and Gynaecology, San Martino Hospital, University of Genoa, Via San Martino 63-8, 16131 Genova, Italy Tel: +39 010 511525; fax: +39 010 511525; e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.