{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T22:37:48Z","timestamp":1768948668539,"version":"3.49.0"},"reference-count":33,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"publication aid program of the Medical University of Gda\u0144sk","award":["61-00206"],"award-info":[{"award-number":["61-00206"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: This study explores the diagnostic and management pathways for dyspareunia in women seeking specialist care, focusing on gynecologists\u2019 feedback and women\u2019s perceptions of their experience. Methods: An online survey was conducted among 225 sexually active women to explore their perceptions of dyspareunia, its impact on relationships, and experiences with healthcare feedback, diagnosis, and treatment. The Numeric Rating Scale (NRS) for pain assessment and the Female Sexual Function Index (FSFI) were used. Gynecologists\u2019 feedback was classified as positive, neutral, or negative based on its influence on the therapeutic pathway. Results: Of 78 women reporting dyspareunia, 12 with pain level \u22655 on NRS were selected for in-depth analysis. The mean pain score was 7.0 \u00b1 1.53, with symptoms lasting from several months to over two years and occurring during most sexual encounters. The mean FSFI score was 24.86 \u00b1 4.54, with half of the participants scoring within the sexual dysfunction range. Qualitative findings revealed frequent dismissive responses from healthcare professionals and limited access to appropriate management. Common self-management strategies included changing sexual positions and using lubricants, while half of the participants had not undergone a formal diagnostic process. Most frequent diagnoses were hormonal disorders and recurrent genital tract infections, and women were advised to undergo pharmacological treatment. Half of the participants were unaware of the possibility of physiotherapeutic management. Conclusions: Women with dyspareunia often face an inadequate diagnostic and therapeutic process. The care received is often insufficient and not aligned with a biopsychosocial model.<\/jats:p>","DOI":"10.3390\/jcm15020787","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T09:24:34Z","timestamp":1768901074000},"page":"787","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring the Diagnostic and Therapeutic Pathways of Women with Dyspareunia: A Mixed-Methods Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7877-4984","authenticated-orcid":false,"given":"Joanna","family":"Wojtas","sequence":"first","affiliation":[{"name":"Department of Gynecology, Obstetrics and Neonatology, Medical University of Gda\u0144sk, Smoluchowskiego 17, 80-214 Gda\u0144sk, Poland"},{"name":"Independent Team of Physiotherapists, University Clinical Center, al. Zwyci\u0119stwa 30, 80-219 Gda\u0144sk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4482-1500","authenticated-orcid":false,"given":"Zofia","family":"Sotomska","sequence":"additional","affiliation":[{"name":"Independent Team of Physiotherapists, University Clinical Center, al. Zwyci\u0119stwa 30, 80-219 Gda\u0144sk, Poland"},{"name":"Department of Clinical Physiotherapy, Medical University of Gda\u0144sk, Zwyci\u0119stwa 30, 80-219 Gda\u0144sk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9519-823X","authenticated-orcid":false,"given":"Marek","family":"Murawski","sequence":"additional","affiliation":[{"name":"Department of Gynecological Surgery and Oncology, Wroclaw Medical University, 50-367 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5311-3450","authenticated-orcid":false,"given":"Magdalena Emilia","family":"Grzybowska","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Obstetrics and Neonatology, Medical University of Gda\u0144sk, Smoluchowskiego 17, 80-214 Gda\u0144sk, Poland"},{"name":"Department of Obstetrics and Gynecology, Gynecologic Oncology and Gynecologic Endocrinology, University Clinical Center, D\u0119binki 7, 80-952 Gda\u0144sk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.sxmr.2018.12.007","article-title":"Deep dyspareunia: Review of pathophysiology and proposed future research priorities","volume":"8","author":"Orr","year":"2020","journal-title":"Sex. Med. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.rhm.2015.11.008","article-title":"Sexual health in the International Classification of Diseases (ICD): Implications for measurement and beyond","volume":"23","author":"Chou","year":"2015","journal-title":"Reprod. Health Matters"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1689","DOI":"10.1111\/1471-0528.14518","article-title":"Painful sex (dyspareunia) in women: Prevalence and associated factors in a British population probability survey","volume":"124","author":"Mitchell","year":"2017","journal-title":"BJOG"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1080\/03630242.2017.1306606","article-title":"Struggles for medical legitimacy among women experiencing sexual pain: A qualitative study","volume":"58","author":"Braksmajer","year":"2018","journal-title":"Women Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/j.sxmr.2017.06.005","article-title":"Deep dyspareunia in endometriosis: A proposed framework based on pain mechanisms and genito-pelvic pain penetration disorder","volume":"5","author":"Yong","year":"2017","journal-title":"Sex. Med. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1002\/ca.22187","article-title":"Physical therapy management of female chronic pelvic pain: Anatomic considerations","volume":"26","author":"George","year":"2012","journal-title":"Clin. Anat."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/s11930-015-0053-y","article-title":"Female sexual pain disorders: A review of the literature on etiology and treatment","volume":"7","author":"Bergeron","year":"2015","journal-title":"Curr. Sex. Health Rep."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/j.1743-6109.2006.00393.x","article-title":"REVIEWS: Pelvic floor involvement in male and female sexual dysfunction and the role of pelvic floor rehabilitation in treatment: A literature review","volume":"4","author":"Rosenbaum","year":"2007","journal-title":"J. Sex. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1007\/s10508-009-9563-x","article-title":"The DSM diagnostic criteria for dyspareunia","volume":"39","author":"Binik","year":"2010","journal-title":"Arch. Sex. Behav."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, APA. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1097\/YCO.0000000000000098","article-title":"Female sexual pain disorders","volume":"27","author":"Simonelli","year":"2014","journal-title":"Curr. Opin. Psychiatry"},{"key":"ref_12","first-page":"465","article-title":"Dyspareunia in women","volume":"90","author":"Seehusen","year":"2014","journal-title":"Am. Fam. Physician"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1097\/AOG.0b013e3181a1ba2a","article-title":"Evaluation and treatment of dyspareunia","volume":"113","author":"Steege","year":"2009","journal-title":"Obstet. Gynecol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1089\/jwh.2008.1133","article-title":"Help-seeking behaviour of women with self-reported distressing sexual problems","volume":"18","author":"Shifren","year":"2009","journal-title":"J. Women\u2019s Health"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1007\/s10508-021-02244-w","article-title":"Sexual difficulties, problems, and help-seeking in a national representative sample: The second australian study of health and relationships","volume":"51","author":"Richters","year":"2022","journal-title":"Arch. Sex. Behav."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1111\/j.1743-6109.2010.02150.x","article-title":"Early dyspareunia experience in young women: Confusion, consequences, and help-seeking barriers","volume":"8","author":"Donaldson","year":"2011","journal-title":"J. Sex. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2669","DOI":"10.1007\/s10508-023-02589-4","article-title":"Gynecological cancer survivors\u2019 experiences of dyspareunia and factors influencing care-seeking behavior: A qualitative study","volume":"52","author":"Cyr","year":"2023","journal-title":"Arch. Sex. Behav."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"100480","DOI":"10.1016\/j.ssmqr.2024.100480","article-title":"People discuss the men who can\u2019t get it up, but what about the women who can\u2019t get it in? Women\u2019s help-seeking experiences for sexual pain-penetration disorder","volume":"6","author":"Pithavadian","year":"2024","journal-title":"SSM-Qual. Res. Health"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2134","DOI":"10.1111\/1475-6773.12117","article-title":"Achieving integration in mixed methods designs\u2014Principles and practices","volume":"48","author":"Fetters","year":"2013","journal-title":"Health Serv. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1111\/jsm.12012","article-title":"Development and validation of the Polish version of the Female Sexual Function Index in the Polish population of females","volume":"10","author":"Nowosielski","year":"2013","journal-title":"J. Sex. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1111\/j.1743-6109.2008.01166.x","article-title":"How young does vulvo-vaginal pain begin? Prevalence and characteristics of dyspareunia in adolescents","volume":"6","author":"Landry","year":"2009","journal-title":"J. Sex. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1080\/0092623X.2018.1549631","article-title":"Physical therapy intervention for women with dyspareunia: A randomized clinical trial","volume":"45","author":"Schvartzman","year":"2019","journal-title":"J. Sex Marital Ther."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1849","DOI":"10.1007\/s00192-019-04019-3","article-title":"Pelvic floor rehabilitation in the treatment of women with dyspareunia: A randomized controlled clinical trial","volume":"30","author":"Ghaderi","year":"2019","journal-title":"Int. Urogynecology J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1016\/j.esxm.2019.06.010","article-title":"Sexual Dysfunction in Menopausal Women","volume":"7","author":"Michalski","year":"2019","journal-title":"Sex. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1037\/ccp0000072","article-title":"A randomized clinical trial comparing group cognitive\u2013behavioral therapy and a topical steroid for women with dyspareunia","volume":"84","author":"Bergeron","year":"2016","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.sxmr.2016.06.004","article-title":"Physical Therapy in the Treatment of Central Pain Mechanisms for Female Sexual Pain","volume":"5","author":"Vandyken","year":"2017","journal-title":"Sex. Med. Rev."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"S13","DOI":"10.1016\/j.jsxm.2022.05.031","article-title":"Rate of Prior Invasive Pelvic Procedures, Co-Diagnoses, and Treatment Choices in Women Presenting with Dyspareunia\u2013A United States Claims Database Analysis","volume":"19","author":"Dumas","year":"2022","journal-title":"J. Sex. Med."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Fern\u00e1ndez-P\u00e9rez, P., Leir\u00f3s-Rodr\u00edguez, R., Marqu\u00e9s-S\u00e1nchez, M.P., Mart\u00ednez-Fern\u00e1ndez, M.C., de Carvalho, F.O., and Maciel, L.Y.S. (2023). Effectiveness of physical therapy interventions in women with dyspareunia: A systematic review and meta-analysis. BMC Women\u2019s Health, 23.","DOI":"10.1186\/s12905-023-02532-8"},{"key":"ref_29","unstructured":"Engeler, D., Baranowski, A.P., Berghmans, B., Birch, J., Borovicka, J., Cottrell, A.M., Dinis-Oliveira, P., Elneil, S., Hughes, J., and Messelink, E.J. (2026, January 10). EAU Guidelines on Chronic Pelvic Pain. European Association of Urology. Available online: https:\/\/d56bochluxqnz.cloudfront.net\/documents\/full-guideline\/EAU-Guidelines-on-Chronic-Pelvic-Pain-2022_2022-03-29-084111_kpbq.pdf."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1007\/s11930-019-00188-w","article-title":"Dyspareunia in Women: Updates in Mechanisms and Current\/Novel Therapies","volume":"11","author":"Caruso","year":"2019","journal-title":"Curr. Sex. Health Rep."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Hutton, D., Mustafa, A., Patil, S., Rathod, S., Shrikhande, G., Advincula, A., Drummond, J., Gregersen, P., Hall, J., and Metz, C. (2023). The burden of Chronic Pelvic Pain (CPP): Costs and quality of life of women and men with CPP treated in outpatient referral centers. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0269828"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/j.1525-1497.2004.30059.x","article-title":"Effect of a Biopsychosocial Approach on Patient Satisfaction and Patterns of Care","volume":"19","author":"Margalit","year":"2004","journal-title":"J. Gen. Int. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1111\/1471-0528.17987","article-title":"Biopsychosocial Approaches for the Management of Female Chronic Pelvic Pain: A Systematic Review","volume":"132","author":"Johnson","year":"2025","journal-title":"BJOG Int. J. Obstet. Gynaecol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/787\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T09:47:03Z","timestamp":1768902423000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/787"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,19]]},"references-count":33,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["jcm15020787"],"URL":"https:\/\/doi.org\/10.3390\/jcm15020787","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,19]]}}}