Resumen
La dispareunia es un problema común en mujeres postmenopáusicas que a menudo no se trata adecuadamente.
Los fisioterapeutas pueden desempeñar un papel importante en la evaluación y tratamiento de la dispareunia, especialmente cuando se debe a un suelo pélvico hipertónico.
Los clínicos deben abordar activamente el tema de la dispareunia con sus pacientes utilizando cuestionarios orales o escritos.
Además de la historia médica y el examen físico, se pueden usar diversas herramientas para una evaluación más exhaustiva, incluyendo dilatadores vaginales, imágenes y biopsias vulvares.
Los tratamientos pueden incluir lubricantes, hidratantes, estrógenos vaginales, terapia con testosterona local y fisioterapia del suelo pélvico.
La coordinación entre fisioterapeutas, médicos y terapeutas sexuales puede ser necesaria para un tratamiento efectivo.
La importancia de la fisioterapia en el tratamiento de la dispareunia
El fisioterapeuta juega un papel crucial en el abordaje de la dispareunia, una disfunción sexual que afecta tanto a hombres como a mujeres. En las clínicas de fisioterapia, los profesionales pueden ofrecer terapias especializadas para tratar el dolor y mejorar la calidad de vida de los pacientes. Este artículo brinda información relevante sobre cómo la fisioterapia puede marcar la diferencia en el tratamiento de la dispareunia.
Abstract original
Diagnosis, causes, and treatment of dyspareunia in postmenopausal women
Importance and objectives: Evaluation and treatment of dyspareunia remains a significant unmet need despite the availability of safe and effective treatments. The objectives of this review are to consider evaluation techniques, the medical causes, and treatment options for dyspareunia in postmenopausal women.
Methods: This narrative review used PubMed to search for English-language articles related to postmenopausal dyspareunia. Search terms included, but were not limited to, dyspareunia, genitourinary syndrome of menopause, sexual dysfunction, postmenopausal dyspareunia, posthysterectomy dyspareunia, and postcancer dyspareunia.
Findings: Many postmenopausal women with dyspareunia do not discuss their symptoms with their physicians. Healthcare clinicians should broach the topic of dyspareunia with their patients using oral or written questionnaires. In addition to a thorough medical history and physical examination, various tools can be used as further assessments, including vaginal pH, vaginal dilators, imaging, vulvar biopsy, vulvoscopy and photography, the cotton swab test, sexually transmitted infection screening, and vaginitis testing. Although dyspareunia in postmenopausal women is often due to the genitourinary syndrome of menopause, other conditions can also cause dyspareunia, including hypertonic pelvic floor, hysterectomy, cancer treatment, lichen conditions, vulvar cancer, vestibulodynia, and pelvic organ prolapse. Some of the treatments discussed include lubricants, moisturizers, vaginal estrogen, ospemifene, dehydroepiandrosterone, local testosterone therapy, cannabidiol, and fractional CO2 laser treatments. In some cases, dyspareunia may need to be specifically addressed by pelvic floor physical or sex therapists.
Conclusions: Dyspareunia is a common issue in postmenopausal women, which remains largely untreated. Women with dyspareunia require a thorough history, targeted physical examination, and coordination of multiple disciplines including medical clinicians, pelvic floor physical therapists, and sex therapists.
| Autores | Lauren F Streicher |
| revista | Menopause |
| DOI | 10.1097/GME.0000000000002179 |