Differential Diagnosis for Pain with Orgasm
- Single Most Likely Diagnosis
- Vaginismus: This condition, characterized by involuntary muscle spasms in the vaginal wall, is a common cause of pain during orgasm. The muscle contractions can lead to significant discomfort or pain, making it a likely diagnosis for pain experienced during climax.
- Other Likely Diagnoses
- Vulvodynia: A condition that causes chronic pain in the vulva, which can be exacerbated during sexual activity, including orgasm. The pain can range from mild to severe and is often described as burning or stabbing.
- Endometriosis: A condition where tissue similar to the lining inside the uterus grows outside of it, leading to pain during menstruation, intercourse, and sometimes during orgasm due to the location and extent of the endometrial implants.
- Pelvic Inflammatory Disease (PID): An infection of the female reproductive organs that can cause pain during sexual activity, including pain with orgasm, due to inflammation and scarring in the pelvic region.
- Do Not Miss Diagnoses
- Ovarian Cysts or Torsion: While less common, ovarian cysts can cause severe pain, especially if they rupture or torsion occurs. The pain can be acute and may be associated with sexual activity, including orgasm.
- Ectopic Pregnancy: Although rare, an ectopic pregnancy can cause severe abdominal pain and may be associated with sexual activity. It's a medical emergency that requires immediate attention.
- Rare Diagnoses
- Pudendal Neuralgia: A condition characterized by damage to the pudendal nerve, which can cause chronic pain in the vulva, vagina, or perineum. The pain can be exacerbated by sitting or sexual activity, including orgasm.
- Interstitial Cystitis: A condition causing bladder pressure, bladder pain, and sometimes pelvic pain. The symptoms can worsen with sexual activity, including pain during orgasm, though this is less common.