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Yitzchak M. Binik - One of the best experts on this subject based on the ideXlab platform.

  • can fear Pain and muscle tension discriminate vaginismus from dyspareunia provoked vestibulodynia implications for the new dsm 5 diagnosis of genito pelvic Pain penetration disorder
    Archives of Sexual Behavior, 2015
    Co-Authors: Marie-andrée Lahaie, Rhonda Amsel, Samir Khalifé, Stephanie C Boyer, Marie Faaborgandersen, Yitzchak M. Binik
    Abstract:

    Fear has been suggested as the crucial diagnostic variable that may distinguish vaginismus from dyspareunia. Unfortunately, this has not been systematically investigated. The primary purpose of this study, therefore, was to investigate whether fear as evaluated by subjective, behavioral, and psychophysiological measures could differentiate women with vaginismus from those with dyspareunia/provoked vestibulodynia (PVD) and controls. A second aim was to re-examine whether Genital Pain and pelvic floor muscle tension differed between vaginismus and dyspareunia/PVD sufferers. Fifty women with vaginismus, 50 women with dyspareunia/PVD, and 43 controls participated in an experimental session comprising a structured interview, Pain sensitivity testing, a filmed gynecological examination, and several self-report measures. Results demonstrated that fear and vaginal muscle tension were significantly greater in the vaginismus group as compared to the dyspareunia/PVD and no-Pain control groups. Moreover, behavioral measures of fear and vaginal muscle tension were found to discriminate the vaginismus group from the dyspareunia/PVD and no-Pain control groups. Genital Pain did not differ significantly between the vaginismus and dyspareunia/PVD groups; however, Genital Pain was found to discriminate both clinical groups from controls. Despite significant statistical differences on fear and vaginal muscle tension variables between women suffering from vaginismus and dyspareunia/PVD, a large overlap was observed between these conditions. These findings may explain the great difficulty health professionals experience in attempting to reliably differentiate vaginismus from dyspareunia/PVD. The implications of these data for the new DSM-5 diagnosis of Genito-Pelvic Pain/Penetration Disorder are discussed.

  • The DSM Diagnostic Criteria for Dyspareunia
    Archives of Sexual Behavior, 2010
    Co-Authors: Yitzchak M. Binik
    Abstract:

    The DSM-IV-TR attempted to create a unitary category of dyspareunia based on the criterion of Genital Pain that interfered with sexual intercourse. This classificatory emphasis of interference with intercourse is reviewed and evaluated from both theoretical and empirical points of view. Neither of these points of view was found to support the notion of dyspareunia as a unitary disorder or its inclusion in the DSM-V as a sexual dysfunction. It seems highly likely that there are different syndromes of dyspareunia and that what is currently termed “superficial dyspareunia” cannot be differentiated reliably from vaginismus. It is proposed that the diagnoses of vaginismus and dyspareunia be collapsed into a single diagnostic entity called genito-pelvic Pain/penetration disorder. This diagnostic category is defined according to five dimensions: percentage success of vaginal penetration; Pain with vaginal penetration; fear of vaginal penetration or of genito-pelvic Pain during vaginal penetration; pelvic floor muscle dysfunction; medical co-morbidity.

  • does vaginismus exist a critical review of the literature
    Journal of Nervous and Mental Disease, 1999
    Co-Authors: Elke D. Reissing, Yitzchak M. Binik, Samir Khalifé
    Abstract:

    The basic strategies and methods for assessing and treating vaginismus were proposed by the early 20th century and have not essentially changed. Etiological theories have changed over time but are not supported by controlled empirical studies. This critical review of the literature disputes the widely held belief that vaginismus is an easily diagnosed and easily treated sexual dysfunction. We propose a reconceptualization of vaginismus as either an aversion/phobia of vaginal penetration or a Genital Pain disorder.

Ronald B George - One of the best experts on this subject based on the ideXlab platform.

  • prevalence and predictors of genito pelvic Pain in pregnancy and postpartum the prospective impact of fear avoidance
    The Journal of Sexual Medicine, 2014
    Co-Authors: Maria Glowacka, Natalie O. Rosen, Jill Chorney, Erna Snelgrove Clarke, Ronald B George
    Abstract:

    Abstract Introduction There is limited knowledge regarding the symptom profile of genito-pelvic Pain in pregnancy and postpartum, and potential psychosocial predictors of this Pain. Prior studies have reported a positive association between prepregnancy Pain and postpartum genito-pelvic Pain. Greater fear avoidance has been associated with increased Genital Pain intensity in women, unrelated to childbirth. This relationship has not been examined prospectively in a postpartum population. Aims The study aims were to examine the symptom profile of genito-pelvic Pain during pregnancy and at 3 months postpartum, and the impact of prepregnancy nongenito-pelvic Pain and fear avoidance in pregnancy on genito-pelvic Pain at 3 months postpartum. Methods First-time expectant mothers (N = 150) completed measures of fear avoidance (Pain-related anxiety, catastrophizing, hypervigilance to Pain), prepregnancy nongenito-pelvic Pain, childbirth-related risk factors (e.g., episiotomy), and breastfeeding. Main Outcome Measures Those reporting genito-pelvic Pain in pregnancy and/or at 3 months postpartum answered questions about the onset (prepregnancy, during pregnancy, postpartum) and location (Genital, pelvic, or both) of the Pain and rated the intensity and unpleasantness of the Pain on numerical rating scales. Results Of 150 women, 49% reported genito-pelvic Pain in pregnancy. The Pain resolved for 59% of women, persisted for 41%, and 7% of women reported a new onset of genito-pelvic Pain after childbirth. Prepregnancy nongenito-pelvic Pain was associated with an increased likelihood of postpartum onset of genito-pelvic Pain. Greater Pain-related anxiety was associated with greater average genito-pelvic Pain intensity at 3 months postpartum. Conclusions Results suggest that about half of women may develop genito-pelvic Pain during pregnancy, which will persist for about a third, and a subset will develop this Pain after childbirth. Prior recurrent nongenito-pelvic Pain may enhance the risk of developing genito-pelvic Pain postpartum, while greater Pain-related anxiety in pregnancy may increase the risk for greater intensity of postpartum genito-pelvic Pain. Glowacka M, Rosen N, Chorney J, Snelgrove−Clarke E, and George RB. Prevalence and predictors of genito-pelvic Pain in pregnancy and postpartum: The prospective impact of fear avoidance. J Sex Med 2014;11:3021–3034.

Talli Y Rosenbaum - One of the best experts on this subject based on the ideXlab platform.

  • musculoskeletal Pain and sexual function in women
    The Journal of Sexual Medicine, 2010
    Co-Authors: Talli Y Rosenbaum
    Abstract:

    ABSTRACT Introduction Sexual Pain disorders refer to conditions of Genital Pain that interfere with intercourse. They often have a musculoskeletal component related to the pelvic floor and are included in the DSM-IV as sexual dysfunctions. Musculoskeletal Pain (MP) that is not essentially Genitally based often interferes with sex as well yet is not considered a distinct sexual dysfunction. MP is generally addressed by physiatrists, orthopedists, and rheumatologists who are not traditionally trained in sexual medicine, and therefore, the sexual concerns of women with MP often go unaddressed. Aim The purposes of this review article were to describe how MP is perceived in the literature as affecting sexual function, illustrate how specific MP conditions prevalent in women may affect sexual function, and offer recommendations for clinical practice. Methods PubMed and Medline searches were performed using the keywords “musculoskeletal Pain and sex,”“lower back Pain and sex,”“arthritis and sex,” and “fibromyalgia and sex”. Main Outcome Measure Review of the peer-reviewed literature. Results Most studies cite fatigue, medication, and relationship adjustment as affecting sexuality much as chronic illness does. While musculoskeletal contributors to Genital sexual response and Pain are considered relevant to sexual function, little is understood about how MP syndromes specifically affect sexual activity. Conclusion Lack of mobility and MP can restrict intercourse and limit sexual activity, and gender differences are noted in response to Pain. Sexual and relationship counseling should be offered as a component of rehabilitative treatment. Physical therapists are uniquely qualified to provide treatment to address functional activities of daily living, including sexual intercourse, and offer advice for modifications in positioning. Rosenbaum TY. Musculoskeletal Pain and sexual function in women.

  • continuing medical education the role of pelvic floor physical therapy in the treatment of pelvic and Genital Pain related sexual dysfunction cme
    The Journal of Sexual Medicine, 2008
    Co-Authors: Talli Y Rosenbaum, Annette Owens
    Abstract:

    Introduction. Chronic pelvic Pain (CPP) in women and men is associated with significant sexual dysfunction. Recently, musculoskeletal factors have been recognized as significant contributors to the mechanism of pelvic Pain and associated sexual dysfunction, and in particular, pelvic floor muscle hypertonus has been implicated. Aim. The purpose of this Continuing Medical Education article is to describe the musculoskeletal components involved in pelvic and Genital Pain syndromes and associated sexual dysfunction, introduce specific physical therapy assessment and intervention techniques, and provide suggestions for facilitating an effective working relationship among practitioners involved in treating these conditions. Methods. A review of the relevant literature was performed, clarifying current definitions of pelvic Pain, elucidating the role of musculoskeletal factors, and determining the efficacy of physical therapy interventions. Results. A review of the role of physical therapy for the treatment of pelvic Pain and related sexual dysfunction. Conclusions. Physical therapy treatment of pelvic Pain is an integral component of the multidisciplinary approach to CPP and associated sexual dysfunction. Rosenbaum TY, and Owens A. The role of pelvic floor physical therapy in the treatment of pelvic and Genital Pain-related sexual dysfunction. J Sex Med 2008;5:513-523.

Annette Owens - One of the best experts on this subject based on the ideXlab platform.

  • continuing medical education the role of pelvic floor physical therapy in the treatment of pelvic and Genital Pain related sexual dysfunction cme
    The Journal of Sexual Medicine, 2008
    Co-Authors: Talli Y Rosenbaum, Annette Owens
    Abstract:

    Introduction. Chronic pelvic Pain (CPP) in women and men is associated with significant sexual dysfunction. Recently, musculoskeletal factors have been recognized as significant contributors to the mechanism of pelvic Pain and associated sexual dysfunction, and in particular, pelvic floor muscle hypertonus has been implicated. Aim. The purpose of this Continuing Medical Education article is to describe the musculoskeletal components involved in pelvic and Genital Pain syndromes and associated sexual dysfunction, introduce specific physical therapy assessment and intervention techniques, and provide suggestions for facilitating an effective working relationship among practitioners involved in treating these conditions. Methods. A review of the relevant literature was performed, clarifying current definitions of pelvic Pain, elucidating the role of musculoskeletal factors, and determining the efficacy of physical therapy interventions. Results. A review of the role of physical therapy for the treatment of pelvic Pain and related sexual dysfunction. Conclusions. Physical therapy treatment of pelvic Pain is an integral component of the multidisciplinary approach to CPP and associated sexual dysfunction. Rosenbaum TY, and Owens A. The role of pelvic floor physical therapy in the treatment of pelvic and Genital Pain-related sexual dysfunction. J Sex Med 2008;5:513-523.

Sylvie Aubin - One of the best experts on this subject based on the ideXlab platform.

  • original research sexual Pain disorders the association between sexual function Pain and psychological adaptation of men diagnosed with chronic pelvic Pain syndrome type iii
    The Journal of Sexual Medicine, 2008
    Co-Authors: Sylvie Aubin, Richard E Berger, Julia R Heiman, Marcia A Ciol
    Abstract:

    ABSTRACT Introduction Prostatitis/chronic pelvic Pain syndrome (CPPS) is known to have a negative impact on quality of life, especially on intimate relationships and sexual function. Information is, however, missing on the contribution of demographic and psychological variables to sexual variables. Aim We compared the sexual function of men with CPPS to men without Pain, and examined the relationship between the sexual, demographic, and psychological measures in men with CPPS. Main Outcome Measures Self-report questionnaires assessing demographic, Pain, sexual function, and psychological adaptation. Methods The sample consisted of 72 men diagnosed with CPPS and 98 men without any Pain condition. Self-report questionnaires measuring demographic, Pain, and sexual function were completed once at the eligibility visit by all subjects. CPPS subjects completed additional questionnaires related to Pain and psychological adaptation. Results CPPS subjects differed from controls by reporting significantly less frequent sexual desire or thoughts, less frequent sexual activities, less arousal/erectile function, less orgasm function, and higher frequencies of Genital Pain during/after intercourse. When we adjusted for age and marital status, the difference between groups remained for thoughts/desire, frequency of sexual activity, and arousal/erectile function. Analysis of factors related to sexual function in CPPS subjects included Pain status and psychological adaptation. Results showed that frequency of sexual activity decreased with increasing depression, whereas arousal/erectile function decreased with increasing Pain symptoms and stress appraisal. Orgasm function decreased with increasing depression and pleasure/satisfaction decreased with increasing Pain symptoms, stress appraisal, and decreasing belief of a relationship between emotions and Pain. Conclusions We found a differential sexual profile for men with CPPS when compared to men without Pain. The results suggest that interventions addressing psychological factors affecting sexual responses should be further studied in prospective clinical trials as one possible way to improve sexual function and satisfaction in men with CPPS. Aubin S, Berger RE, Herman JR, and Ciol MA. The association between sexual function, Pain, and psychological adaptation of men diagnosed with chronic pelvic Pain syndrome type III