Differential Diagnosis
- Single most likely diagnosis
- Vaginal Atrophy or Vaginal Dryness: This condition is likely due to the patient's prolonged period of abstinence from intercourse, leading to decreased estrogen levels and vaginal dryness. The symptoms of pain, dryness, and burning during vaginal and oral sex are consistent with this diagnosis. The burning sensation while urinating could be related to the vaginal dryness or a possible urinary tract infection (UTI) secondary to the vaginal atrophy.
- Other Likely diagnoses
- Yeast Infection: The patient's symptoms of burning and pain during sex, as well as the burning sensation while urinating, could be indicative of a yeast infection. The fact that she had oral sex performed on her, which can introduce bacteria into the vagina, increases the likelihood of this diagnosis.
- Bacterial Vaginosis: Similar to a yeast infection, bacterial vaginosis could be caused by the introduction of bacteria into the vagina during oral sex. The symptoms of burning, pain, and discharge are consistent with this diagnosis.
- Urinary Tract Infection (UTI): The patient's burning sensation while urinating could be indicative of a UTI, which could be related to the vaginal dryness or the introduction of bacteria into the urinary tract during intercourse.
- Do Not Miss
- Sexually Transmitted Infection (STI): Although the patient's symptoms may not be typical of an STI, it is essential to consider this possibility, especially given the introduction of a new sexual activity. STIs such as gonorrhea, chlamydia, or herpes could present with similar symptoms.
- Vaginal Tear or Laceration: The patient's pain and burning during sex could be indicative of a vaginal tear or laceration, which would require prompt medical attention.
- Rare diagnoses
- Lichen Sclerosus: This is a rare condition that can cause vaginal dryness, pain, and burning. Although it is less likely, it should be considered in the differential diagnosis.
- Vulvar Vestibulitis: This condition is characterized by chronic pain and burning in the vulvar area, which could be exacerbated by sex. Although it is rare, it should be considered in the differential diagnosis.