BPS/IC is a chronic disorder characterized by chronic pelvic pain, pressure, or discomfort perceived to be related to the urinary bladder accompanied by at least one urinary symptom such as persistent urge to void or urinary frequency. Sexual dysfunction symptoms have been reported for women with BPS/IC, including lack of libido and of sexual interest, pain during intercourse, and vulvodynia. The exact prevalence of sexual dysfunction among women with BPS/IC is unknown, but it seems to range between 13 and 87 %, and worse sexual functioning has been observed among patients with BPS/IC than among the general population or age-matched control patients. Alteration in arousal, lubrication, and orgasm, together with dyspareunia and vulvodynia, is the most frequently reported sexual dysfunction in women affected by BPS/IC. From a neurophysiological point of view, chronic inflammation induces pain following chronic changes in neurotransmission, mechanisms of pain control, and tissue responses. Endometriosis is a common cause of chronic pelvic pain in women and is diagnosed in up to 80 % of BPS/IC. The baseline evaluation includes history and physical and laboratory examination in order to assess the presence of BPS/IC and exclude other diseases with similar symptoms, such as vaginismus, vulvar vestibulitis, vulvodynia, atrophic tissue or impaired lubrication, adnexal pathology, chronic cervicitis, pelvic inflammatory disease, and urethra disorders. Any eventual confusable disease should be diagnosed and excluded. Condition-specific symptom questionnaires, psychosocial parameters, and QoL questionnaires should be used to adequately assess patients with BPS/IC. Treatment should be approached in many directions, including psychological and social aspects. Patients should be educated that BPS/IC is a chronic condition associated with relapsing and remitting phases with a gradual progression to a more severe condition along time. Changes in diet and lifestyle can help reduce symptoms and bladder retraining by reducing voiding frequency in some patients with the disease. When the patients’ symptoms do not respond to nonpharmacological treatment, it is necessary to move toward pharmacological interventions. A combination of oral and intravesical therapies together with lifestyle intervention and physical therapy can gradually improve pain and urinary symptoms in patients affected by BPS/IC, although an evidence-based management approach has not yet been developed.

Giannantoni, A. (2017). Female sexuality in chronic pelvic pain. In D.V. E. Costantini (a cura di), Female sexual function and dysfunction (pp. 157-167). Springer International Publishing [10.1007/978-3-319-41716-5_14].

Female sexuality in chronic pelvic pain

Giannantoni, Antonella
2017-01-01

Abstract

BPS/IC is a chronic disorder characterized by chronic pelvic pain, pressure, or discomfort perceived to be related to the urinary bladder accompanied by at least one urinary symptom such as persistent urge to void or urinary frequency. Sexual dysfunction symptoms have been reported for women with BPS/IC, including lack of libido and of sexual interest, pain during intercourse, and vulvodynia. The exact prevalence of sexual dysfunction among women with BPS/IC is unknown, but it seems to range between 13 and 87 %, and worse sexual functioning has been observed among patients with BPS/IC than among the general population or age-matched control patients. Alteration in arousal, lubrication, and orgasm, together with dyspareunia and vulvodynia, is the most frequently reported sexual dysfunction in women affected by BPS/IC. From a neurophysiological point of view, chronic inflammation induces pain following chronic changes in neurotransmission, mechanisms of pain control, and tissue responses. Endometriosis is a common cause of chronic pelvic pain in women and is diagnosed in up to 80 % of BPS/IC. The baseline evaluation includes history and physical and laboratory examination in order to assess the presence of BPS/IC and exclude other diseases with similar symptoms, such as vaginismus, vulvar vestibulitis, vulvodynia, atrophic tissue or impaired lubrication, adnexal pathology, chronic cervicitis, pelvic inflammatory disease, and urethra disorders. Any eventual confusable disease should be diagnosed and excluded. Condition-specific symptom questionnaires, psychosocial parameters, and QoL questionnaires should be used to adequately assess patients with BPS/IC. Treatment should be approached in many directions, including psychological and social aspects. Patients should be educated that BPS/IC is a chronic condition associated with relapsing and remitting phases with a gradual progression to a more severe condition along time. Changes in diet and lifestyle can help reduce symptoms and bladder retraining by reducing voiding frequency in some patients with the disease. When the patients’ symptoms do not respond to nonpharmacological treatment, it is necessary to move toward pharmacological interventions. A combination of oral and intravesical therapies together with lifestyle intervention and physical therapy can gradually improve pain and urinary symptoms in patients affected by BPS/IC, although an evidence-based management approach has not yet been developed.
2017
978-3-319-41714-1
978-3-319-41716-5
Giannantoni, A. (2017). Female sexuality in chronic pelvic pain. In D.V. E. Costantini (a cura di), Female sexual function and dysfunction (pp. 157-167). Springer International Publishing [10.1007/978-3-319-41716-5_14].
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11365/1064924