Gynecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda, 12, 20122, Milan, Italy.
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Arch Gynecol Obstet. 2024 Mar;309(3):887-893. doi: 10.1007/s00404-023-07205-3. Epub 2023 Sep 9.
Deep dyspareunia is one of the main symptoms of endometriosis. It appears to be submerged by a two-way disconnection between patients and their physicians. The aim of our review is to provide clear, ready-to-use advice on how to manage deep dyspareunia overcoming the gap in communication. Sexual history should always be taken as part of routine health care in these regards, using a patient-centered approach. An educational pelvic examination, which actively includes patients in the identification of painful areas, may prove useful to improve patients' understanding of their condition. Correlating painful pelvic areas with sexual positions and inviting patients to adopt alternative positions may represent a simple but extremely effective coping strategy to mitigate pain. Revealing and explaining to partners the nature of the pain is essential to allow them to take part in shared research of coping mechanisms, empowering the couple to make choices and changes. Couples who do not feel comfortable talking about intimacy by themselves may find that including a psychotherapist or a sexual therapist, may be a good way to start communication. Investigating and managing dyspareunia during medical encounters is a medical and ethical duty all healthcare practitioners should pursue.
深部性交痛是子宫内膜异位症的主要症状之一。它似乎是由于患者和医生之间的双向脱节而被掩盖了。我们的综述旨在提供明确、即用型的建议，以克服沟通障碍来管理深部性交痛。在这方面，应始终将性病史作为常规保健的一部分，采用以患者为中心的方法。教育性骨盆检查主动让患者参与识别疼痛区域，可能有助于提高患者对自身病情的理解。将疼痛的盆腔区域与性姿势相关联，并邀请患者采用替代姿势，可能是一种简单但非常有效的应对策略，可以减轻疼痛。向伴侣揭示和解释疼痛的性质对于允许他们参与应对机制的共同研究至关重要，使夫妻能够做出选择和改变。对于那些自己不愿意谈论亲密关系的夫妇来说，可能会发现请心理治疗师或性治疗师介入是开始沟通的好方法。在医疗就诊中调查和管理性交痛是所有医疗保健从业者都应该追求的医学和伦理责任。
