{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T11:04:19Z","timestamp":1784113459142,"version":"3.55.0"},"reference-count":28,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Dyspareunia in peri\u2010 and postmenopausal women is common, clinically consequential, and often undertreated in gynecologic practice. Although genitourinary syndrome of menopause (GSM) is a frequent contributor, intercourse\u2010related pain may also reflect vestibular, pelvic floor, dermatologic, inflammatory, treatment\u2010related, and psychosocial factors. This narrative review provides a practical phenotype\u2010based framework for assessment and management when GSM, vestibular pain, and pelvic floor dysfunction coexist, and when deep\u2010pain phenotypes require broader pelvic evaluation. PubMed\/MEDLINE, the Cochrane Library, and selected guideline sources were searched for English\u2010language literature published from January 2014 to March 2026, prioritizing guidelines, systematic reviews, randomized or sham\u2010controlled trials, and examination\u2010based studies relevant to office gynecology. History should distinguish superficial from deep pain, provoked from spontaneous symptoms, and urinary, dermatologic, inflammatory, and psychosocial features. Examination should proceed from vulva and vestibule to vagina and pelvic floor, with bimanual assessment and selective imaging when deeper pathology is suspected. Management includes education, irritant avoidance, moisturizers and lubricants, and prescription therapy for clinically significant GSM, usually low\u2010dose vaginal estrogen, with prasterone or ospemifene as selected alternatives. Pelvic floor physiotherapy should be considered when tenderness, guarding, or penetration\u2010limiting hypertonicity is present. Because menopause\u2010specific pelvic floor evidence remains limited, related recommendations are framed as cautious extrapolations from broader dyspareunia, vulvodynia, and chronic pelvic pain literature.<\/jats:p>","DOI":"10.1002\/ijgo.71238","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T10:17:16Z","timestamp":1784110636000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessment and management of dyspareunia in peri\u2010 and postmenopausal women: A phenotype\u2010based gynecologic approach"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5652-1652","authenticated-orcid":false,"given":"Marek","family":"Broul","sequence":"first","affiliation":[{"name":"Department of Sexology Krajsk\u00e1 zdravotn\u00ed, a.s. \u2014 Masaryk Hospital  Usti nad Labem Czech Republic"},{"name":"Department of Urology Krajsk\u00e1 zdravotn\u00ed, a.s. \u2014 Litomerice Hospital  Litomerice Czech Republic"},{"name":"Faculty of Health Studies Jan Evangelista Purkyne University in Usti nad Labem  Usti nad Labem Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Van\u010do","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Health Studies Jan Evangelista Purkyne University in Usti nad Labem and Krajsk\u00e1 zdravotn\u00ed, a.s. \u2014Masaryk Hospital  Usti nad Labem Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4182-8341","authenticated-orcid":false,"given":"Jaroslava","family":"Ban\u00fdrov\u00e1","sequence":"additional","affiliation":[{"name":"Faculty of Physical Education and Sport Charles University  Prague Czech Republic"},{"name":"Private Medical Practice, Jaroslava Banyrova  Usti nad Labem Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3773-2902","authenticated-orcid":false,"given":"Aneta","family":"Hujov\u00e1","sequence":"additional","affiliation":[{"name":"Faculty of Health Studies Jan Evangelista Purkyne University in Usti nad Labem  Usti nad Labem Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"e_1_2_18_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jsm.12686"},{"key":"e_1_2_18_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/GME.0000000000001609"},{"key":"e_1_2_18_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000004589"},{"key":"e_1_2_18_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2016.06.010"},{"key":"e_1_2_18_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/GME.0000000000001956"},{"key":"e_1_2_18_7_1","doi-asserted-by":"publisher","DOI":"10.36290\/uro.2024.061"},{"key":"e_1_2_18_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsxm.2016.02.167"},{"key":"e_1_2_18_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-018-3603-9"},{"key":"e_1_2_18_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001645"},{"key":"e_1_2_18_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/ANNALS-24-00610"},{"key":"e_1_2_18_12_1","doi-asserted-by":"publisher","DOI":"10.23970\/AHRQEPCCER272"},{"key":"e_1_2_18_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/sxmrev\/qeaf055"},{"key":"e_1_2_18_14_1","unstructured":"National Institute for Health and Care Excellence.Menopause: identification and management. 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