Dyspareunia

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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.

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2 Information Resources for Patients and Carers

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3 Development and Updates to this Pathway

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4 Referral Forms

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9 Examination

Vulva, vagina and cervix visualised, bimanual performed.
If suspect cancer refer as appropriate

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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