Endometriosis: This condition is characterized by the growth of endometrial tissue outside the uterus, leading to inflammation, scarring, and adhesions. It is a common cause of deep dyspareunia (painful intercourse), especially with deep penetration.

Vaginismus: A condition where the vaginal muscles involuntarily contract, making penetration painful or impossible. It can be primary (always present) or secondary (develops after a period of normal sexual function).
Pelvic Inflammatory Disease (PID): An infection of the female reproductive organs that can cause chronic pain, especially with deep penetration, due to adhesions and scarring.
Ovarian Cysts: Large or ruptured ovarian cysts can cause pain during deep penetration due to the pressure on the ovaries or surrounding structures.
Uterine Fibroids: These benign tumors can cause pain during intercourse, especially if they are large or located in a position that puts pressure on surrounding structures.

Ectopic Pregnancy: Although less common, an ectopic pregnancy can cause severe pain during intercourse, especially if the pregnancy is advanced or has ruptured. Missing this diagnosis can be life-threatening.
Appendicitis: Inflammation of the appendix can cause lower abdominal pain that worsens with deep penetration or movement. Appendicitis requires prompt surgical intervention to prevent rupture.
Ovarian Torsion: A rare but emergency condition where the ovary twists around its ligaments, cutting off blood supply. It can cause severe pain that may be exacerbated by deep penetration.

Vaginal Cancer: A rare type of cancer that can cause pain during intercourse due to the tumor's location and size.
Foreign Body in the Vagina: The presence of a foreign object in the vagina can cause pain, especially with deep penetration.
Malpositioned or Perforated Intrauterine Device (IUD): An IUD that is not properly positioned or has perforated the uterus can cause pain during intercourse, including deep dyspareunia.