Jakarta (ANTARA) – For married couples (couples) having sex on the first night feels like heaven on earth. However, some women felt that they were really suffering.
There are several terms in medicine, starting from pain during sexual intercourse or pain during sexual intercourse. dyspareunia, dysparenia, difficult matingfor painful relationship,
This definition includes recurrent or persistent discomfort that occurs before, during or after sexual intercourse. Dispareni to is a complex disease that can be classified in surface dyspareunia (Superficial) or deep dyspareunia (Deep)and dispareni to primary or dispareni to Secondary.
Superficial dyspareunia it's in pain vulva or vaginal access and dispareni to pain in the vagina or lower pelvis, usually associated with deep, deep penetration.
Primary dyspareunia occurs at the beginning of the relationship, while secondary dysparonia occurs after a few relationships with pleasure.
In short, according to the International Pain Research Association, dyspareunia is an unpleasant sensory-emotional experience of the potential for tissue damage.
The term dyspareunia is usually vulvodinia, Dispareni to is a descriptive terminology that describes the symptoms of pelvic or vaginal pain associated with sexual intercourse, such as pain sensations that occur with a touch of sexual intercourse.
vulvodinia can occur with or without provocation, the nickname is spontaneous. Dispareni to may occur at the entrance of the vagina, deep in the vaginal canal or in the pelvis. vulvodinia vulva and vaginal introitus.
Dispareni to acute (transient, short) or chronic (long, chronic), whereas vulvodinia It is especially used in the classification of chronic pain (lasting more than three months).
Both terms can be used to describe the sense of pain or pain that comes with it. comorbidity like endometriosis, interstitial cystitis, pelvic myalgia bottom and vulvar dermatoses,
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Complaint and research methodology
10-15 percent of fertile women are sexually active and 3-33 percent of women perimenopause Dyspareunia was caught in various degrees. Differences in clinical reporting depend on many factors, such as the type of population considered (general clinical or specialist clinic), choice bias, the quality of attention paid to clinicians by sexual complaints, the quality of clinicians' listening skills, and the disclosure and discussion of complaints.
prevalence dispareni to It ranges from 0.4 percent to 61 percent. This high range is likely due to significant methodological differences between studies, including the study population, the diversity of definitions of dyspareunia, and the parameters used to evaluate them.
World Health Organization Journal 2006 study dyspareunia report event dispareni to 8-22 percent. This figure varies in different countries.
prevalence dispareni to it depends on how you define it and your geographic location. For example, the prevalence of dyspareunia in the United States reaches 10 1020 percent, with major causes varying with age groups.
A systematic review in Brazil in 2016 revealed the frequency of dyspepsia between 1.2 and 56.1 percent. The prevalence rate in Puerto Rico is between 17 percent and 21 percent.
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Dispareni to is a specific pain disorder with interdependent psychobiological etiology. May be associated with superficial dyspareunia vaginitis, dermatosis, and vulvovaginitis.
Instead of "dispareni to "pelvic inflammatory disease may occur due to visceral abnormalities such as interstitial cystitis, endometriosis, adhesions, pelvic obstruction and fibroids. Pain syndrome has the potential to overlap and dispareni to and vulvodiniaincluding irritable bowel syndrome, fibromyalgia, and dysfunction musculoskeletal.
Biological factors cause dyspareunia, eg microangiopathy or vascular disease atherosclerosis secondary to hypercholesterolemia, smoking or age.
Meana et al. (1997) found that pain and onset in sexual intercourse were the most powerful determinants of organic etiology. Various psychosocial variables such as situational factors, relationship adjustments, and a history of sexual abuse have no predictive value.
Other conditions that contribute to the development of dyspareunia such as poor vaginal lubrication, vaginal shrinkage (atrophy) and childbirth.
Birth is a risk factor for pelvic pain and / or development. dispareni to during and after the postpartum period.
A cross-sectional study of the effects of childbirth on sexual health reported that 17 to 36 percent of women reported dyspareunia six months after childbirth, but only 15 percent of postpartum dyspareunia patients consult health care providers.
Dispareni to In general, happiness, quality of marital relationship, physical and emotional satisfaction, orgasm response, frequency of intimate relationships, desire level and desire / passion can reduce.
Comprehensive clinical interview (date retrieval) Competent physical examination will contribute to the accurate diagnosis of dyspareunia etiology for unknown reasons such as organic dysparenia, psychogenic dysparenia, mixed dysparenia or dysparenia.
The diagnosis in the second group can be dramatically reduced by the inclusion of classical medical measures to approach pain disorders and to demonstrate a competent and clear attitude towards the diagnosis of female sexual disorders.
When measuring pain, the approved personal reporting questionnaire is McGill's Pain Questionnaire (McGill Pain SurveyFemale Sexual Function Index)Female Sexual Function Index) or discomfort scale vulva PROMIS (Patient Reported Results Measurement Information System) It is very useful compared to asking patients to measure the pain level from one to ten.
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Dispareni to It is a heterogeneous disease with various causes, treatment can sometimes expand as a function of physical pathology which is thought to play a role in causing pain.
However, research has shown that dyspareunia is multifactorial, physical pathology, psychosocial, genetic and neuroimunobiocomedicine (NiBTM) can be described in detail and in detail.
A diagnosis that combines various medicopsychosexual factors is the first step in the effective management of dyspareunia; a situation that requires physiopathologically oriented management of organic and therapeutic factors related to psychosexual problems of individuals and couples.
According to Dunkley and Brotto (2016), psychotherapeutic approaches can help reduce pain or a sense of sexual pain. Cognitive and awareness therapy used in the treatment of depression and anxiety also shows efficacy in the treatment. PVD (provoked vestibulodynia),
Rehabilitation of the pelvic floor muscles is narrowed defensively with chronic coitus pain and is particularly important in the treatment of dyspareunia.
This includes scarring, tension and relaxation of the muscles, which are sure to cause pain, resulting from the use of local estrogen replacement therapy in cases of vaginal dystrophy.
When muscle relaxation is achieved, active dilatation of the introitus with fingers and dilators seems to be clinically useful in reducing dyspnea and providing coitus function to normal, provided that it is libido with sufficient passions.
There are several non-pharmacological approaches to dyspareunia. For example, patient education, dyspareunia, stopping various activities that irritant and aggravate medication, lubrication during coitus, changes in mating position, avoid deep penetration, plunge into warm or cold water, use vaginal dilators according to doctor's instructions.
Then, relaxation techniques often exercise the vaginal muscles (one with Kegel exercises), exclude pathological tissue, and guarantee the disease to patients who are not severe, as indicated by surgery / surgery. Some psychosocial interventions such as behavior change, general counseling, marriage / relationship counseling, systemic desensitization techniques can be done.
An interdisciplinary approach involving the contributions of multidisciplinary (eg gynecologists, sexologists, psychiatrists, pain therapists) is required to provide comprehensive and sustainable management for dyspnea patients.
*) Dito Anurogo MSc is a permanent lecturer at FK Unismuh Makassar, director of the Indonesian Stem Cell Association, the 2019 national literacy literacy instructor.
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By Dito Anurogo MSc
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