Vaginal Pain

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Vaginal Pain

 

Definition

Pain in the vaginal canal is usually associated with an underlying medical and/or psychological condition.

Description

Vaginal pain is experienced usually during vaginal manipulation or sexual intercourse. Approximately 50-85% of the causes are due to organic (medical) conditions. However, it is typical for the medical condition to be compounded by psychological issues such as depression and problems associated with sexual identity. The primary entity concerns dyspareunia, a vaginal pain experienced during sexual intercourse. The vagina has three physiological functions: an outflow duct for menstrual discharge, to receive the penis during sexual intercourse, and as the birthing canal. The overall prevalence for dyspareunia is 20% (15% of women and 57% of men). A significant percentage of breast cancer and hysterectomy patients demonstrated sexual dysfunction.

Causes and symptoms

The causes can be categorized as organic, due to a medical condition and/or psychological difficulties. Medical conditions can include chronic diseases, minor ailments, breast cancer, and medications. Psychological cause can be related to physical or sexual abuse. Pregnancy and hormonal changes (decreased estrogen) have significant negative impact on sexual activity, desire, and satisfaction. Dyspareunia can be divided into three types of pain: superficial, vaginal, and deep. Superficial pain is associated with attempted penetration. This is usually caused by changes in anatomy, irritative condition, or vaginismus. Vaginal pain is associated with friction, indicating a problem with lubrication and/or arousal disorders. Deep pain is related to thrusting and is indicative of pelvic disease or an inability for pelvic relaxation.

Key terms

Anthrax — An infectious disease caused by a type of bacterium. The disease can be passed from animals to people and usually is fatal. Symptoms include sores on the skin.Antibody — A type of protein produced in the blood or in the body tissues that helps the body fight infection.Bacteria — Tiny, one-celled forms of life that cause many diseases and infections.Cholera — An infection of the small intestine caused by a type of bacterium. The disease is spread by drinking water or eating seafood or other foods that have been contaminated with the feces of infected people. It occurs in parts of Asia, Africa, Latin America, India, and the Middle East. Symptoms include watery diarrhea and exhaustion.Encephalitis — Inflammation of the brain, usually caused by a virus. The inflammation may interfere with normal brain function and may cause seizures, sleepiness, confusion, personality changes, weakness in one or more parts of the body, and even coma.Feces — The solid waste that is left after food is digested. Feces form in the intestines and pass out of the body through the anus. Also called stool.Guillain-Barré syndrome (GBS) — A disease of the nerves with symptoms that include sudden numbness and weakness in the arms and legs, sometimes leading to paralysis. The disease is serious and requires medical treatment, but most people recover completely.Immune system — The body's natural defenses against disease and infection.Immunization — A process or procedure that protects the body against an infectious disease. A vaccination is a type of immunization.Inflammation — Pain, redness, swelling, and heat that usually develop in response to injury or illness.Meningitis — Inflammation of tissues that surround the brain and spinal cord.Microorganism — An organism that is too small to be seen with the naked eye.Organism — An individual of some type of life form, such as a plant, an animal, or a microorganism.Plague — A highly infectious disease that can be fatal if not treated promptly. The bacteria that cause plague mainly infect rats, mice, squirrels, and other wild rodents. The disease is passed to people through fleas. Infected people can then spread the disease to other people.Seizure — A sudden attack, spasm, or convulsion.Tuberculosis — An infectious disease that usually affects the lungs, but may also affect other parts of the body. Symptoms include fever, weight loss, and coughing up blood.Typhoid fever — An infectious disease caused by a type of bacterium. People with this disease have a lingering fever and feel depressed and exhausted. Diarrhea and rose-colored spots on the chest and abdomen are other symptoms. The disease is spread through poor sanitation.Virus — A tiny, disease-causing particle that can reproduce only in living cells.Yellow fever — An infectious disease caused by a virus. The disease, which is spread by mosquitoes, is most common in Central and South America and Central Africa. Symptoms include high fever, jaundice (yellow eyes and skin) and dark-colored vomit, a sign of internal bleeding. Yellow fever can be fatal.

Diagnosis

The diagnosis must be pursued with diligence and in a comprehensive manner. A careful history and physical examination is essential. Procedures that can be used include surgical investigation (laparoscopy) and treatment of the underlying cause(s).

Treatment

Treatment is directed at diagnosing the underlying condition, which can be medical and/or psychological cause(s). Treatment can include surgery, hormonal therapy (replacements), psychotherapy, and pain control protocols.

Prognosis

The prognosis depends on the primary cause. If treatment is aggressively pursued and patient compliance is satisfactory the overall outcome is favorable.

Prevention

There are no precise preventive measures since the condition can result from normal aging and/or progressively worsening psychological disease.

Resources

Books

Goroll, Allan H., et al. Primary Care Medicine. 4th ed. Lippincott, Williams & Wilkins, 2000.Ryan, Kenneth J., et al, editors. Kistner's Gynecology & Women's Health. 7th ed. Mosby, Inc., 1999.

Key terms

Anthrax — An infectious disease caused by a type of bacterium. The disease can be passed from animals to people and usually is fatal. Symptoms include sores on the skin.Antibody — A type of protein produced in the blood or in the body tissues that helps the body fight infection.Bacteria — Tiny, one-celled forms of life that cause many diseases and infections.Cholera — An infection of the small intestine caused by a type of bacterium. The disease is spread by drinking water or eating seafood or other foods that have been contaminated with the feces of infected people. It occurs in parts of Asia, Africa, Latin America, India, and the Middle East. Symptoms include watery diarrhea and exhaustion.Encephalitis — Inflammation of the brain, usually caused by a virus. The inflammation may interfere with normal brain function and may cause seizures, sleepiness, confusion, personality changes, weakness in one or more parts of the body, and even coma.Feces — The solid waste that is left after food is digested. Feces form in the intestines and pass out of the body through the anus. Also called stool.Guillain-Barré syndrome (GBS) — A disease of the nerves with symptoms that include sudden numbness and weakness in the arms and legs, sometimes leading to paralysis. The disease is serious and requires medical treatment, but most people recover completely.Immune system — The body's natural defenses against disease and infection.Immunization — A process or procedure that protects the body against an infectious disease. A vaccination is a type of immunization.Inflammation — Pain, redness, swelling, and heat that usually develop in response to injury or illness.Meningitis — Inflammation of tissues that surround the brain and spinal cord.Microorganism — An organism that is too small to be seen with the naked eye.Organism — An individual of some type of life form, such as a plant, an animal, or a microorganism.Plague — A highly infectious disease that can be fatal if not treated promptly. The bacteria that cause plague mainly infect rats, mice, squirrels, and other wild rodents. The disease is passed to people through fleas. Infected people can then spread the disease to other people.Seizure — A sudden attack, spasm, or convulsion.Tuberculosis — An infectious disease that usually affects the lungs, but may also affect other parts of the body. Symptoms include fever, weight loss, and coughing up blood.Typhoid fever — An infectious disease caused by a type of bacterium. People with this disease have a lingering fever and feel depressed and exhausted. Diarrhea and rose-colored spots on the chest and abdomen are other symptoms. The disease is spread through poor sanitation.Virus — A tiny, disease-causing particle that can reproduce only in living cells.Yellow fever — An infectious disease caused by a virus. The disease, which is spread by mosquitoes, is most common in Central and South America and Central Africa. Symptoms include high fever, jaundice (yellow eyes and skin) and dark-colored vomit, a sign of internal bleeding. Yellow fever can be fatal.