Dyspareunia
1 Background Information / Scope of Pathway
These pathways were developed to guide clinicians when managing dyspareunia
The pathways are not provider specific and so the guidance and forms apply to all providers.
2 Information Resources for Patients and Carers
3 Development and Updates to this Pathway
4 Referral Forms
9 Examination
Vulva, vagina and cervix visualised, bimanual performed.
If suspect cancer refer as appropriate
13 Treatment
- Treat with sensitivity – this can very upsetting and difficult for women to talk about.
- Give general advice about good vulval skin care – see BAD.org.uk ‘care of vulval skin’ patient information leaflet - http://www.bad.org.uk/shared/get-file.ashx?id=74&itemtype=document
- Manage and treat any underlying cause.
- A trial of vaginal oestrogen can be considered if genitourinary syndrome of the menopause (GSM) is suspected
- General advice specific to superficial dyspareunia
- Advice on use of adequate over the counter or prescription lubrication – water, silicone or oil based (although beware condom use and oil based lubricants.)
- Vaginal moisturisers used regularly or prn can be helpful – e.g. Replens (licensed)
- Dilators can be prescribed or bought if symptoms persist after the underlying condition has been treated – e.g. prescribe Amielle comfort dilators(licensed). Advise to start with the smallest most comfortable dilator, insert for approx. 10 mins every day and move up to the next size when ready.
- Psychosexual counselling may be needed – refer as appropriate