CIDPUSA.ORG Autoimmune Disease

Female medical Issue

Gynecologic Causes of Female Sexual Dysfunction and Method of Gynecologic Examination
External genitalia
Assess muscle tone Vaginismus
Assess skin color and texture Vulvar dystrophy, dermatitis
Assess skin turgor and thickness Atrophy
Assess pubic hair amount and distribution Atrophy
Expose clitoris Clitoral adhesions
Assess for ulcers Herpes simplex virus
Perform cotton swab test of vestibule Vulvar vestibulitis
Palpate Bartholin glands Bartholinitis
Assess posterior forchette and hymenal ring Episiotomy scars, strictures
Palpate rectovaginal surface Rectal disease
Palpate levator ani Levator ani myalgia, vaginismus
Palpate bladder/urethra Urethritis, interstitial cystitis, urinary tract infection
Assess for cervical motion tenderness Infection, peritonitis
Assess vaginal depth Postoperative changes, postradiation changes, stricture
Palpate uterus Retrogression, fibroids, endometritis
Palpate adnexa Masses, cysts, endometriosis, tenderness
Perform rectovaginal examination Rule out endometriosis
Obtain guaiac test Bowel disease
Evaluate discharge, pH Vaginitis, atrophy
Evaluate vaginal mucosa Atrophy
Perform Papanicolaou smear Human papillomavirus infection, cancer
Assess for prolapse Cystocele, rectocele, uterine prolapse

continue to page -4

Adapted with permission from Phillips NA. The clinical evaluation of dyspareunia. Int J Impot Res 1998;(suppl 2):S117-20.