Although qualitative research on dyspareunia has increased in recent years, most studies have focused on women's individual experiences or on specific difficulties within the couple, leaving underexplored how partners jointly construct the meanings of sexuality when pain becomes part of the relationship. Against this backdrop, this study explored how couples make sense of sexuality and how their interactional processes shape the relational patterns through which they navigate intimacy in the presence of pain. Drawing on episodic interviews with nine Italian heterosexual couples (M age = 34 years) affected by dyspareunia associated with vulvodynia and/or endometriosis, we conducted a reflexive thematic analysis through which four themes were co-constructed: "Between Body and Emotion: The Shifting Landscape of Sexuality"; "He Holds Back, She Consents: Silent Sacrifices"; "Together Alone: When Coping Is Delegated"; and "From Pain to Partnership: Reimagining Sexuality Together." Across narratives, couples described greater connection and intimacy when they were able to co-construct meanings and activate communicative spaces grounded in acknowledgment, mutual support, and negotiation. These findings underscore the importance of couple-centered clinical interventions that focus on interactive processes and promote reciprocity and a shared redefinition of sexuality. Adopting a relational and dialogical lens, the study highlights sexuality not as an individual function disrupted by pain, but as an evolving co-created process through which partners continually remake intimacy together.

The current term "Genitourinary Syndrome of Menopause" (GSM) was introduced to replace "vulvovaginal atrophy" and to better describe a constellation of symptoms affecting the genital and lower urinary tracts due to hypoestrogenism. However, its association with menopause excludes a growing and diverse population of individuals who experience identical symptoms due to non-menopausal etiologies, including perimenopause, lactation, hormonal contraception, cancer therapies, gender-affirming hormone therapy, and other medications. This paper proposes an expanded and updated nomenclature-Genitourinary Syndrome (GS)-with specific subtypes based on etiology. We review the pathophysiologic mechanisms underlying genitourinary symptoms across populations, highlight gaps in clinical recognition due to narrow terminology, and recommend a clinically and scientifically inclusive reclassification system. This shift is crucial for delivering equitable care, advancing research, and providing effective patient education.

OBJECTIVES: To (1) estimate the prevalence of pelvic floor symptoms in performing artists and artistic athletes and (2) quantify the impact of symptoms during and outside performance and training. DESIGN: Epidemiology systematic review with meta-analysis. LITERATURE SEARCH: Six databases were searched from inception to February 2025. STUDY SELECTION CRITERIA: Studies involving participants from any artistic discipline and with data on pelvic floor symptom or disorder prevalence or impact were included. DATA SYNTHESIS: Critical appraisal was conducted using the JBI (Joanna Briggs Institute) Critical Appraisal Checklist, and the certainty of evidence was judged using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework. Data were pooled for pelvic floor symptom proportions in performing artists and artistic athletes, with subgroup analyses for any type of urinary incontinence by discipline. We descriptively synthesized pelvic floor symptoms and impact data that were not included in the meta-analysis. RESULTS: Nineteen articles were included. Half (52%; 95% confidence interval [CI]: 38%, 66%; I[2] = 92.7%) of the performing artists and artistic athletes reported urinary incontinence, 79% (95% CI: 69%, 88%; I[2] = 80.6%) reported anal incontinence, and 47% (95% CI: 41%, 53%; I[2] = not reported (NR)) reported dyspareunia. The discipline most affected by any type of urinary incontinence was trampolining (87%; 95% CI: 70%, 98%; I[2] = NR). Up to 83% of the performing artists and artistic athletes reported some negative impact from their symptoms. CONCLUSION: At least half of the performing artists and artistic athletes reported pelvic floor symptoms, particularly urinary and flatal incontinence. The symptoms negatively impacted 83% of the athletes during performance. J Orthop Sports Phys Ther 2026;56(8):530-545. Epub September 19 2025. doi:10.2519/jospt.2025.13452.