Diagnostic Tests for Dyspareunia
Dyspareunia Tests: Book Excerpts
Home Diagnostic Testing
These home medical tests may be relevant to Dyspareunia:
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Dyspareunia Diagnosis: Book Excerpts
Diagnostic Tests for Dyspareunia: Online Medical Books
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DYSPAREUNIA:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
It is extremely important to look for evidence of sexual abuse both on history and physical examination before undertaking an expensive workup. Routine studies include a CBC, sedimentation rate, urinalysis, urine culture and sensitivity, and vaginal smear and culture. A Pap smear should also be done. If pregnancy is suspected, a pregnancy test should be done. If there is a pelvic mass, pelvic ultrasound may be helpful. A referral to a gynecologist is usually made before ordering this study, however. If vulval dystrophy is suspected, a vaginal biopsy may be useful. If the vaginal examination is normal, perhaps a psychiatrist should be consulted.
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Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
Dyspareunia:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
Begin by asking the patient to describe the pain. Does it occur with attempted penetration or deep thrusting? How long does it last? Is the pain intermittent or does it always accompany intercourse? Ask whether changing coital position or using a vaginal lubricant relieves the pain.
Next, ask about a history of pelvic, vaginal, or urinary tract infection. Does the patient have signs and symptoms of a current infection? Have her describe any discharge. Also, ask about malaise, headache, fatigue, abdominal or back pain, nausea and vomiting, and diarrhea or constipation.
Obtain a sexual and menstrual history. Determine whether dyspareunia is related to the patient’s menstrual cycle. Are her cycles regular? Ask about dysmenorrhea and metrorrhagia. Has the patient had a baby? If so, did she have an episiotomy? Note whether she’s breast-feeding. Ask about previous abortion, sexual abuse, or pelvic surgery. Also, find out what contraceptive method the patient uses. Does her partner use condoms? Does he or could he have a latex allergy? Then try to determine her attitude toward sexual intimacy. Does she feel tense during coitus? Is she satisfied with the length of foreplay? Does she usually achieve orgasm? Ask about a history of rape, incest, or sexual abuse as a child.
Next, perform a physical examination, starting with vital signs. Palpate the abdomen for tenderness, pain, or masses and for inguinal lymphadenopathy. Finally, inspect the genitalia for lesions and vaginal discharge.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
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