Sexual Pain Disorders Introduction

For most people, the anticipation of, or reflection about, sexual exchange conjures up images of sexual passion, abandonment, pleasure, and intimacy. However, for a significant minority of women and men, the anticipation of sex is associated with feelings and fears of discomfort, irritation, disappointment, and pain. For these individuals, sex is often frustrating and uncomfortable, an activity to be dreaded or avoided. Unfortunately, complaints of dyspareunia (recurrent or persistent genital pain associated with sexual intercourse [American Psychiatric Association 1994]) or vaginismus (recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that interferes with vaginal penetration [American Psychiatric Association 1994]) are far from infrequent.

As a result of a 1998 Consensus Conference on Female Sexual Disorders, in which a group of 19 experts on female sexuality assembled to update and refine the diagnoses of female sexual dysfunctions, it was recommended that all sexual disorders should include a substantial element of personal distress in order to warrant diagnosis. A new diagnosis was also proposed at that meeting, namely noncoital sexual pain disorder (defined as recurrent or persistent genital pain that is induced by noncoital sexual stimulation and that causes personal distress). Although this diagnostic entity has not received formal recognition, it is important to note that both women and men may experience sexual pain when engaging in sexual behaviors other than intercourse.