Differential Diagnosis for Pain with Intercourse
Single Most Likely Diagnosis
- Vaginismus: This condition, characterized by involuntary muscle spasms in the vaginal wall, is a common cause of pain during intercourse, particularly in women who have not previously experienced pain-free intercourse.
Other Likely Diagnoses
- Vulvodynia: A chronic condition that involves pain in the vulva, which can be exacerbated by intercourse, making it a likely cause of pain during sexual activity.
- Endometriosis: A condition where tissue similar to the lining inside the uterus grows outside of it, leading to pain during intercourse due to the irritation and inflammation of the affected areas.
- Vaginal Dryness: Often associated with menopause or other hormonal changes, vaginal dryness can cause discomfort or pain during intercourse.
- Pelvic Inflammatory Disease (PID): An infection of the female reproductive organs that can cause pain during intercourse, along with other symptoms like abnormal vaginal discharge and fever.
Do Not Miss Diagnoses
- Ovarian Cysts: While not all ovarian cysts cause pain during intercourse, large or ruptured cysts can lead to severe pain and are a condition that should not be missed due to potential complications.
- Ectopic Pregnancy: Although less common, an ectopic pregnancy can cause pain during intercourse, among other symptoms, and is a medical emergency if not promptly diagnosed and treated.
- Cancer of the Reproductive Organs: Cancers such as cervical, uterine, or ovarian cancer can cause pain during intercourse and, while less likely, are critical to diagnose early for effective treatment.
Rare Diagnoses
- Lichen Sclerosus: A rare skin condition that can cause thinning and patchy skin in the genital area, leading to pain during intercourse.
- Mayer-Rokitansky-Küster-Hauser (MRKH) Syndrome: A rare congenital disorder characterized by the underdevelopment or absence of the vagina and uterus, which can cause pain during attempted intercourse.
- Pudendal Neuralgia: A condition involving pain from the pudendal nerve, which can be exacerbated by sitting or intercourse, though it's less commonly associated directly with pain during intercourse compared to other symptoms.