When Pleasure Causes Pain: Living with Interstitial Cystitis

Interstitial cystitis (IC) is a chronic inflammatory condition of the bladder wall associated with genital and bladder pain, urgency, and dyspareunia. Characterized by sterile urine culture, IC is poorly understood and resistant to treatment. This article contextualizes patients' experiences from the standpoint of age, ethnicity, gender, socioeconomic status, and the experience of concomitant disease. More than 90 percent of interstitial cystitis patients are women, an alarming number of whom have been misdiagnosed as having psychiatric disorders. Medical diagnosis and treatment are discussed from a feminist perspective. The sexual functioning of persons with IC is discussed in depth. Topics touched upon include menstrual cycle variations and pregnancy, sexual desire, pain during sexual activity, sexual side-effects of medications, sexual history, and sexual self-care.     

女性性交痛相关因素分析

目的:女性性交痛是困扰女性的常见性问题之一,本研究探讨中国城市女性性交疼痛的相关危险因素,为其防治提供依据。方法:本研究是回顾性调查,调查对象为2009年3～12月在南京医科大学附属南京市妇幼保健院进行健康体检的20岁以上女性及其女性陪护人,发放问卷,调查相关因素,用女性性功能指数问卷评估性功能,性交疼痛评分<4.4分为性交疼痛的筛选标准,采用多因素Logistic回归进行多因素分析。结果:共发放问卷2 658份,有1 856例女性完成问卷,问卷回收率69.8%。排除不符合纳入标准及调查前1个月无性活动者,最终有1 457例受访者资料纳入分析。1 457例受访者中存在不同程度性交痛者626例,占43.0%(626/1475)。Logistic多因素分析表明,年龄(≥50岁)、吸烟、子宫切除、阴道润滑障碍、与配偶缺乏性交流等是女性性交疼痛的独立危险因素(P均<0.05)。结论:女性性交疼痛的发生与年龄(≥50岁)、吸烟、子宫切除、阴道润滑障碍、与配偶缺乏性交流等多种因素相关。     

Dyspareunia: a difficult symptom in gynaecological practice

Dyspareunia is recurrent or persistent genital pain associated with sexual intercourse. It is a symptom that can have a significant impact on women's health, relationships and quality of life. There are multiple different causes for it, including both organic and psychosexual components. Despite the high prevalence of sexual pain, estimated to between 3 and 18% worldwide, few guidelines exist for its evaluation and management. Adequate assessment requires a comprehensive sexual history, a systematic and thorough examination of the lower genital tract to rule out anatomical causes and an exploration of potential psychosexual causes. Further investigations may include swabs and a pelvic ultrasound scan. In some cases a diagnostic laparoscopy may be required if there is evidence of endometriosis or utero-vaginal pathology that does not respond to conservative management. This article considers the diagnosis and investigation of women complaining of dyspareunia.     

Female Sexual Function,Dysfunction, and Pregnancy: Implications for Practice

Women's sexual function is a complex and dynamic interplay of variables that involve physical, emotional, and psychosocial states. Sexual dysfunction may occur at any level, and diagnosing such issues begins with careful assessment through a sexual health history. However, discussions about female sexual health and function are often deficient in the primary care setting. This article reviews the published research on female sexual function, sexual dysfunction, and sexual function in pregnancy to gain a better understanding of how these aspects of a woman's life impact the health care services she receives. The evaluation of female sexual function is in need of consistent measurement tools and more dialogue during health care visits. Women's health care practitioners have an opportunity to advance patient satisfaction and overall health by evaluating and communicating with female patients about their sexual function.     

Sexual problems in women with urinary incontinence. A retrospective study of medical records

The medical records of a consecutive series of 421 women diagnosed at a Department of Gynaecology as having urinary incontinence were surveyed (in retrospect) in order to analyse how frequently sexual complaints had been registered. After exclusion for age above 60 years and for concomitant chronic somatic or psychiatric disease, the charts of 193 women remained. Sexual problems had been registered in 28 (15%) of these. The complaints were dyspareunia, and in two cases decreased sexual desire. In this sample no significant associations between sexual complaints and type/treatment of incontinence, age or number of deliveries were found. As gauged by the available literature these patients have revealed--or have been noted to have--less sexual problems than somatically and psychiatrically healthy females have in the general population.