A 30 year old woman tells you she has experienced pain during sexual intercourse since the birth of her first baby a year ago. She has now lost interest in sex. Her husband is becoming impatient, and she asks you for help. Ask about the nature of the pain―When and where does she feel the pain? Is it near the vaginal entrance on initial penetration or is it felt more deeply on thrusting? Does she have any other abdominal pains? Does she feel that she is "too tight" to allow penetration? The dyspareunia may be accompanied by vaginismus. Does she experience pain every time she attempts intercourse? If not, what is different about the times when she doesn't have pain? Is she more relaxed, and if so why?
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