Pelvic Pain – Interstitial Cystitis
Dyspareunia / Vaginismus
Dyspareunia is persistent pain in allowing attempted vaginal entry or penile intercourse. Vaginismus is persistent difficulty in allowing vaginal entry. It should cause personal distress to the individual. Present for a period of more than 6 months. Pain could be either at the outlet, or deeper or it could be a combination of superficial and deep pain. The prevalence is variable and ranges from 2-20%. The reasons could be due to lack of interest in sex, difficulty in achieving orgasm, lubrication difficulties, sex not pleasurable, and pain or a combination of these factors.
Hypoactive Sexual Desire / Arousal Disorder
Persistent or recurrent, deficient or absent sexual fantasies, and desire for sexual activities causing marked distress. Symptoms usually persist for more than 6 months. Female Sexual Arousal Disorder (FSAD) happens when there is persistent or absent genital swelling or lubrication in response to sexual stimulation. Psychiatric drugs, Antihypertensives, Oral contraceptives can all cause FSAD. Treatment would involve thorough assessment, detailed history with examination, checking for vaginal infections and drugs, CBT, Sex therapy, mindfulness etc.