Sexual Dysfunction and Chronic Genital Pain: An Overview

Introduction:

The WHO (World health organization) states that sexual health is more than just the absence of sickness, malfunction, or infirmity; it is a condition of physical, emotional, mental, and social well-being concerning sexuality. Therefore, a cheerful and considerate attitude is necessary to have sexual relations free of compulsion, discrimination, and violence and for sexual wellness.

What Is the Definition of Sexual Dysfunction?

Sexual dysfunction refers to the inability of a person to engage in a sexual relationship in the way they desire. Sexual response is a complicated process, including physical and psychological factors, and any divergence can lead to sexual dysfunction.

What Are Some of the Most Frequent Male Sexual Dysfunctions?

• Male Erectile Dysfunction or Incompetence - Erectile dysfunction or disorder (ED) refers to a condition in which the male reproductive organ fails to stay erect or maintain an adequate erection for satisfactory intercourse.

• Premature Ejaculation - The coordination of three neurologic events is required for successful antegrade ejaculation - seminal emission, bladder neck closure, and contraction of the pelvic floor muscles. If the musculature of the genital area is affected, premature or retrograde ejaculation may occur.

• Ejaculatory Incompetence - Ejaculatory incompetence is a condition in which a person cannot ejaculate in the vaginal canal. It can be primary or secondary. The last case is when the individual has had an ejaculation problem since the first sexual encounter. In contrast, the second case is when the individual was previously able to do so but is no longer able to.

What Are Some of the Most Frequent Female Sexual Dysfunctions?

1. Vaginismus - It is a condition in which the muscles of the vaginal outer third undergo involuntary spasms in reaction to vaginal penetration attempts.

2. Anorgasmia - It is a medical condition in which a woman's orgasm is absent. Anorgasmia comes in a variety of forms.

• Primary anorgasmia (has never experienced orgasm).

• Secondary anorgasmia (has experienced an orgasm in the past but does not now).

• Situational anorgasmia (only a few scenarios cause an orgasm).

• Coital anorgasmia (when a person experiences orgasms during another sexual act).

3. Dyspareunia - This is the medical name for painful sex, described as persistent or recurrent genital pain that occurs just before, during, or after sex.

What Are the Types of Chronic Genital Pain?

Genital pain, also called vulvodynia, can be of two types -

1. Superficial Pain - Early discomfort is characterized by simple pain in and around the vaginal entrance, perceived as a burning sensation or vaginal dryness.

2. Deep Pain - Pain as a result of pelvic thrust.

How Does Chronic Genital Pain Cause Sexual Dysfunction?

Sexuality and chronic pain have a complicated relationship. Because of the pain or other conditions connected with chronic pain, such as mood disorders, diminished sex drive (libido), drugs, or stress, chronic pain may interfere with your sexuality.

How does Chronic Genital Pain Cause Male Erectile Dysfunction?

Sexual health can be improved by having coordinated and powerful pelvic floor muscles. In addition, increasing pelvic floor muscle tone can significantly contribute to erectile dysfunction by restricting arterial blood flow.

How Does Chronic Genital Pain Cause Anorgasmia?

Arousal in the mind is equally as vital as arousal in the body. A large number of nerve endings can be found in the vaginal area. Chronic vaginal pain prevents stimulation, and as a result, the orgasm is not felt.

What Are the Signs and Symptoms Associated With Chronic Genital Pain (Vulvodynia)?

The signs and symptoms of chronic genital pain include -

• Dryness of the genital organ.

• Vaginal secretion burn.

• Persistent vulvar irritation,burn and pain.

• Recurrent intractable vaginal infections.

• Aversion to speculum examination.

• Painful sexual intercourse.

• Pelvic floor spasms.

• Decreased sex drive.

• The genital area feels swollen.

• Painful menstruation.

What Effect Does Chronic Genital Pain Have On Quality of Life?

Sexual difficulties are caused by genital pain, which leads to -

• Low physical and emotional satisfaction.

• Depression.

• Poor self-esteem.

• Increased anxiety with a sexual partner.

What Are the Causes of Chronic Genital Pain?

The causes of chronic genital pain involve -

• Conditioned pain is caused by involuntary muscle spasms in the lower portion of the vaginal canal.

• Yeast or bacterial infection.

• Chemical or allergic reaction due to clothing, douching, or spermicide.

• Conditions associated with low estrogen such as menopause, postpartum, and lactation.

• Sexual arousal syndrome.

• Use of certain medications, for example, antihypertensive and antidepressant drugs.

• Vessel stenosis (narrowing the genital area is usually seen in conjunction with menopause and surgery).

• Presence of cystocele or rectocele.

• Pelvic inflammatory disease.

• Endometriosis.

• Irritable bowel syndrome.

• Scarring due to childbirth or vaginal surgery.

• Sexual intercourse with a new partner after a long period.

When Do You See a Doctor for Chronic Genital Pain?

• When there is acute genital pain that appears out of nowhere.

• When discomfort interferes with sexual life and hinders one from accomplishing daily tasks.

• If the pain worsens daily, it is time to seek medical help.

What Tests Are Done to Diagnose Chronic Genital Pain?

• Human chorionic gonadotropin (HCG) levels rule out pregnancy.

• Complete blood count to see the number of individual cells.

• Ultrasonography, CT (computed tomography), laparoscopy, and MRI (magnetic resonance imaging) to view the problems associated with internal organs.

How to Treat Chronic Genital Pain?

The optimal treatment depends on the underlying cause.

General instructions include patient education such as -

• Informing the patient that there is no quick fix.

• No douches, bubble baths, or perfumes in the genital area.

• Advise to use a fresh pair of undergarments; try to rinse them even after laundry as the remnant detergent can act as an allergen.

• Preferably use cotton underwear.

Because the treatment for genital discomfort varies based on the underlying cause, below is a list of options.

Treatment for Chronic Genital Pain Due to Vaginal Dryness -

• Increased foreplay.

• Use of water-based lubricants.

• Estrogen local or systemic creams, rings, pills, intradermal patches, and tablets.

Treatment for Chronic Genital Pain Due to Valvular Discomfort -

• Low oxalate diet.

• Local anesthetic gels.

• Using witch hazel pads can reduce the burning sensation after intercourse.

Treatment for Chronic Genital Pain Due to Vaginitis -

• Specific antibacterial or antifungal for the vaginal infection.

• Use of local estrogen supplements.

Treatment for Chronic Genital Pain Due to Vestibulitis -

• Topical estrogen and anesthetic preparations.

• Acupuncture.

• Surgical or laser therapy.

Treatment for Chronic Genital Pain Due to Postpartum Dyspareunia -

• Pelvic floor exercises.

• Restrain any sexual activity within six weeks of childbirth.

Treatment for Chronic Genital Pain Due to Vaginismus -

• Kegels exercises to control vaginal muscles.

• Use of clitoris dilators.

Treatment for Chronic Genital Pain Due to Abrasion -

• Allow the area to heal naturally by avoiding sexual intercourse (abstinence).

What Happens if Chronic Genital Pain Is Left Untreated?

Infertility, infections of the reproductive tract, and extreme discomfort can result from untreated genital pain.

Conclusion:

Chronic genital pain is prevalent and can be caused by either gynecology or non-gynecology factors. In terms of diagnosis, pain quality, severity, and location are critical. Even though the cause of genital pain is diverse, it has a distinct identity. Genital pain caused by infection has a detrimental effect on reproductive health. Early detection and treatment might help to avoid problems and relieve pain.