Sexual Dysfunction Practice Questions

Q: A 23-year-old nulliparous woman complains of painful coitus, with the pain located at the vaginal introitus. This is accompanied by painful involuntary contractions of the pelvic muscles. Pelvic examination is normal, and no obvious local pathology is seen. What is the most common cause of this condition?

Psychological causes. **Explanation:** The clinical presentation described—pain at the vaginal introitus accompanied by involuntary contractions of the pelvic floor muscles (specifically the pubococcygeus muscle) during attempted penetration—is the classic triad of **Vaginismus**. **Why Psychological Causes are correct:** Vaginismus is primarily a psychophysiological condition. While it can be triggered by physical pain, the most common underlying etiology involves **psychological factors** such as fear of pain, sexual trauma, strict religious upbringing, or anxiety regarding intercourse. This leads to a conditioned reflex where the body "protects" itself via involuntary muscle spasms, despite a normal physical anatomy. **Analysis of Incorrect Options:** * **Endometriosis:** Typically causes **deep dyspareunia** (pain deep in the pelvis) rather than introital pain, and is often associated with dysmenorrhea and pelvic masses. * **Bartholin’s Gland Abscess:** This would present with a visible, exquisitely tender, fluctuant swelling at the 4 or 8 o'clock position of the labia majora. The question states the pelvic examination is **normal**. * **Vulvar Atrophy:** Common in postmenopausal women due to estrogen deficiency. It is highly unlikely in a 23-year-old nulliparous woman and would show physical signs like thinning of the mucosa. **Clinical Pearls for NEET-PG:** * **Vaginismus vs. Dyspareunia:** Vaginismus is the *involuntary contraction* preventing entry; Dyspareunia is *pain* during intercourse. * **Management:** The first-line treatment for Vaginismus is **behavioral therapy** and the use of **graded vaginal dilators** (Hegar’s dilators) combined with relaxation techniques. * **Primary vs. Secondary:** Primary vaginismus occurs when a woman has never been able to achieve penetration; secondary occurs after a period of normal function.

Q: Which condition is most commonly associated with female sexual dysfunction characterized by painful intercourse?

Vaginismus. ***Vaginismus*** - **Vaginismus** is a condition characterized by involuntary spasms of the muscles surrounding the vaginal opening, leading to painful intercourse (**dyspareunia**) or inability to complete penetration. - It's a common cause of female sexual dysfunction where the primary symptom is **pain or difficulty with vaginal penetration**. *Absence of ovary* - The **absence of ovaries** primarily affects hormone production and fertility but does not directly cause involuntary vaginal muscle spasms leading to painful intercourse. - While it can lead to vaginal atrophy due to lack of estrogen, which might cause painful intercourse, it's not the most direct or common cause of the specific dysfunction described. *Gonadal dysgenesis* - **Gonadal dysgenesis** refers to abnormal development of the gonads, often leading to hormonal imbalances and infertility. - This condition is not typically associated with muscle spasms causing painful intercourse; its main manifestations are related to sexual development and endocrine function. *Intersex condition* - An **intersex condition** involves atypical development of internal and external sexual anatomy. - While intersex conditions can lead to a variety of sexual health issues, they do not inherently or most commonly present with the involuntary vaginal muscular spasms characteristic of vaginismus.

Question 1

A 22-year-old nulliparous woman, recently sexually active, presents with dyspareunia localized to the vaginal introitus, accompanied by involuntary pelvic muscle contractions. Her pelvic examination is otherwise normal. What is the most common cause of this condition?

Accepted Answer

Psychogenic causes

Answer

Endometriosis

Answer

Bartholin's gland abscess

Answer

Vulvar atrophy

Question 2

A 23-year-old nulliparous woman complains of painful coitus, with the pain located at the vaginal introitus. This is accompanied by painful involuntary contractions of the pelvic muscles. Pelvic examination is normal, and no obvious local pathology is seen. What is the most common cause of this condition?

Accepted Answer

Psychological causes

Answer

Endometriosis

Answer

Bartholin's gland abscess

Answer

Vulvar atrophy

Question 3

Which condition is most commonly associated with female sexual dysfunction characterized by painful intercourse?

Accepted Answer

Vaginismus

Answer

Absence of ovary

Answer

Gonadal dysgenesis

Answer

Intersex condition

Sexual Dysfunction — MCQs

Sexual Dysfunction — MCQs

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