Sexual Pain Disorders in Adolescents

The sexual pain disorders included in different editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R 1987; DSM-IV-TR, 2000) are dyspareunia and vaginismus. Both these clinical entities have undergone intense scrutiny and international discussion in the more recent years (Basson et Al 2003; Binik 2005; Graziottin, 2005; Meana et Al, 1997; Pukall et Al, 2005, Reissing et Al, 2003, 2004). The key issues of current controversies will be summarized, to give the reader an updated perspective. At the same time, the focus of this paper will be on the pathophysiology of dyspareunia and vulvar vestibulitis (Friedrich, 1987), a subset of vulvodynia, which is one of the leading causes of sexual pain disorders in adolescents. Special attention will be devoted to current research on predictors of vulvodynia in this younger cohort (Bouchard et Al, 2002, Harlow et Al. 2001, Harlow & Stewart 2003). The aim is to discuss key practical issues relevant for the clinician, working with adolescents, in his/her daily practice.