What is the difference between superficial and deep dyspareunia?
Superficial dyspareunia refers to pain at the entrance of the vagina, while deep dyspareunia is pain felt deeper in the pelvis during intercourse.
Detailed Medical Explanation
Superficial dyspareunia usually results from vulvar or vaginal problems, such as infections, atrophic vaginitis, or insufficient lubrication. Deep dyspareunia typically arises from conditions affecting the internal pelvic organs, such as endometriosis, pelvic inflammatory disease, or ovarian cysts. Distinguishing the type helps clinicians to tailor diagnostic tests and management. NHS: Painful Sex.
Clinical Context
Identifying whether pain is superficial or deep is essential, as it directs further assessment and treatment. For example, superficial pain may benefit from topical therapies and pelvic floor therapy, while deep pain may require gynaecological investigations or surgery.
Evidence-Based Approaches
Clinical guidelines, such as those from NICE and RCOG, recommend a stepwise approach to diagnosis. Multidisciplinary care and addressing underlying causes are supported by strong evidence. RCOG leaflet.