Steege John F, Zolnoun Denniz A
From the Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Obstet Gynecol. 2009 May;113(5):1124-1136. doi: 10.1097/AOG.0b013e3181a1ba2a.
Dyspareunia affects 8-22% of women at some point during their lives, making it one of the most common pain problems in gynecologic practice. A mixture of anatomic, endocrine, pathologic, and emotional factors combine to challenge the diagnostic, therapeutic, and empathetic skills of the physician. New understandings of pain in general require new interpretations concerning the origins of pain during intercourse, but also provide new avenues of treatment. The outcomes of medical and surgical treatments for common gynecologic problems should routinely go beyond measures of coital possibility, to include assessment of coital comfort, pleasure, and facilitation of intimacy. This review will discuss aspects of dyspareunia, including anatomy and neurophysiology, sexual physiology, functional changes, pain in response to disease states, and pain after gynecologic surgical procedures.
性交困难在8%至22%的女性一生中的某个阶段会出现，这使其成为妇科临床中最常见的疼痛问题之一。解剖学、内分泌学、病理学和情绪因素交织在一起，对医生的诊断、治疗和共情能力构成挑战。对疼痛的新认识不仅需要对性交时疼痛的根源有新的解读，还提供了新的治疗途径。常见妇科问题的药物和手术治疗结果，应常规地超越对性交可能性的衡量，还应包括对性交舒适度、愉悦感和促进亲密关系的评估。本综述将讨论性交困难的各个方面，包括解剖学和神经生理学、性生理学、功能变化、疾病状态下的疼痛以及妇科手术后的疼痛。
