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Personalized Dyspareunia Treatment in Goregaon West, Mumbai

Author:

Dr. Dimple Doshi (MBBS, MD, DGO)
Lady Gynecologist & Laparoscopic Surgeon
27+ years’ experience
20,000+ surgeries completed

The term dyspareunia is usually meant for the pain felt by the women during sexual intercourse. This pain of dyspareunia can be felt either in the genital area or pelvis. The pain may be sharp; intense or more diffuse depending upon the cause.

Dyspareunia is a distressing symptom that may be harmful if the condition causing it is not dealt with properly. Though the majority of times; dyspareunia is very well treatable; it is always better to visit your gynecologist to rule out any serious underlying problem.  

Causes of Dyspareunia

Many conditions can cause dyspareunia; many of them experience it as an emotional problem; while some of them do have a physical problem that leads to real dyspareunia.

Dr. Dimple Doshi at Vardaan Hospital; believes prevention is better than cure, and thus apart from the precise treatment guidelines; preventive measures are an essential part of our consultations with the patients who have either had it or want to know more about it.

Common physical causes of dyspareunia are:
  1. Endometriosis; sometimes with chocolate cysts
  2. Uterine fibroids
  3. PID or pelvic inflammatory disease
  4. Vaginal dryness due to menopause; child birth; breastfeeding; medications or too little arousal before sexual intercourse with lack of lubrication.
  5. Vaginitis
  6. After hysterectomy in some cases or any pelvic surgery.
  7. Skin disorders leading to ulcers; cracks; itching or burning; herpetic eruptions. 
  8. Infections like sexually transmitted diseases; yeast infections or urinary tract infection.
  9. Anatomical defects like a vaginal septum; and abnormally shaped uterus
  10. Injury or trauma from child birth; episiotomy.
  11. Radiation therapy
  1. Stress;
  2. Improper arousal before the sexual act starts.
  3. Fear; guilt or shame related to sexual intercourse.
  4. Medications like birth control pills
  5. Relationship problems and depression.
  6. Past history of sexual abuse or rape.
All these conditions lead to loss of arousal and dyspareunia.

Symptoms of Dyspareunia

  1. Pain during penetration
  2. Pain during or after intercourse.
  3. Deep pain in the pelvis during sexual intercourse.
  4. Burning; itching; aching or stabbing pain or menstrual cramp like pain during sexual intercourse.

What to Expect During Your Visit to Your Gynecologist

Your doctor will take detailed history and the questions include:
    1. When and where do you feel the pain?
    2. How is the pain? Sharp; stabbing; unbearable or diffuse?
    3. Do you get the pain at time of penetration; during intercourse or after the intercourse?
    4. Do any other activities also cause the pain?
    5. Do you get severe pain during the menses also?
    6. Physical examination
  1. Dryness at vulva
  2. Infection or vaginal discharge
  3. Any obstruction at the vaginal opening
  4. Any abnormal masses or warts or ulcers at vulva
  5. Whether the vaginal examination is painful or not.
  1. Pelvic ultrasound
  2. Urine routine test
  3. Vaginal swab testing for culture to test for bacterial or yeast infection.
  4. CT scan or MRI to determine the exact cause if needed.

Treatment of Dyspareunia

  1. Medicines: It includes antibiotics; antifungals; and other medications
  2. HRT: or hormonal replacement therapy  if the vaginal dryness is due to menopause
  3. Local lubricants if the dryness is purely due to lack of lubrication.
  4. Surgery: If dyspareunia is due to fibroids; chocolate cysts or endometriosis.
  5. Consulting with a sexologist can help you get rid of nonphysical causes for dyspareunia.

Home Care for Dyspareunia

  1. Use water soluble lubricants
  2. Relax before starting the sexual activities.
  3. You can take simple painkiller half an hour before the sexual activity.
  4. If it burns after sex; apply ice pack

ICD-10 Codes for Dyspareunia:

Dyspareunia refers to pain experienced during sexual intercourse. Relevant ICD-10 codes include:

  • N94.1: Dyspareunia (painful intercourse)
  • N94.2: Vulvodynia (chronic pain in the vulva which may contribute to dyspareunia)
  • N94.3: Premenstrual tension syndrome (if related to PMS and affecting sexual activity)
  • N94.4: Dysmenorrhea (if related to menstruation and affecting sexual activity)

CPT Codes for Diagnosis and Treatment of Dyspareunia:

Diagnosis and treatment of dyspareunia may involve several procedures:

  1. 99201 – 99215: Office or other outpatient visits (for consultation, evaluation, and management of dyspareunia)
  2. 76830: Ultrasound, transvaginal (to evaluate pelvic structures and identify potential causes of pain)
  3. 58100: Endometrial biopsy (if endometrial pathology is suspected)
  4. 58558: Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D&C (for evaluation and treatment of uterine conditions)
  5. 58660: Laparoscopy, surgical; with lysis of adhesions (if adhesions are contributing to pelvic pain)
  6. 58662: Laparoscopy, surgical; with fulguration or excision of lesions (if endometriosis or other lesions are contributing to pain)
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