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The DSM Diagnostic Criteria for Dyspareunia

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Abstract

The DSM-IV-TR attempted to create a unitary category of dyspareunia based on the criterion of genital pain that interfered with sexual intercourse. This classificatory emphasis of interference with intercourse is reviewed and evaluated from both theoretical and empirical points of view. Neither of these points of view was found to support the notion of dyspareunia as a unitary disorder or its inclusion in the DSM-V as a sexual dysfunction. It seems highly likely that there are different syndromes of dyspareunia and that what is currently termed “superficial dyspareunia” cannot be differentiated reliably from vaginismus. It is proposed that the diagnoses of vaginismus and dyspareunia be collapsed into a single diagnostic entity called genito-pelvic pain/penetration disorder. This diagnostic category is defined according to five dimensions: percentage success of vaginal penetration; pain with vaginal penetration; fear of vaginal penetration or of genito-pelvic pain during vaginal penetration; pelvic floor muscle dysfunction; medical co-morbidity.

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Acknowledgments

The author is a member of the DSM-V Workgroup on Sexual and Gender Identity Disorders (Chair, Kenneth J. Zucker, Ph.D.). I wish to acknowledge the valuable input I received from members of my Workgroup (Lori A. Brotto, Cynthia Graham, and R. Taylor Segraves) and Kenneth J. Zucker. Feedback from DSM-V Work Group Advisors Sophie Bergeron, Marta Meana, and Caroline Pukall is greatly appreciated as is feedback from Seth Davis, Melissa Farmer, Alina Kao, Tuuli Kukkonen, Marie Andrée Lahaie, Caroline Maykut, Laurel Paterson, and Sabina Sarin. Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders V Workgroup Reports (Copyright 2009), American Psychiatric Association.

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  1. Department of Psychology, McGill University, 1205 Dr. Penfield Avenue, Montreal, QC, H3A 1B1, Canada

    Yitzchak M. Binik

  2. Sex and Couple Therapy Service, McGill University Health Center, Montreal, QC, Canada

    Yitzchak M. Binik

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Binik, Y.M. The DSM Diagnostic Criteria for Dyspareunia. Arch Sex Behav 39, 292–303 (2010). https://doi.org/10.1007/s10508-009-9563-x

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