What is the diagnosis for dyspareunia (painful intercourse) with vaginal burning during and after coitus (sexual intercourse)?

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Differential Diagnosis for Vaginal Pain and Burning During and After Sex

Single Most Likely Diagnosis

  • Vulvodynia: This condition is characterized by chronic pain, burning, or discomfort in the vulva, which can be exacerbated by sexual activity. It's a common cause of vaginal pain and burning during and after sex, especially in the absence of other identifiable causes.

Other Likely Diagnoses

  • Vaginal Yeast Infection: A common infection caused by Candida species, leading to itching, burning, and pain during and after sex.
  • Bacterial Vaginosis: An imbalance of vaginal bacteria can cause discomfort, burning, and pain during sexual activity.
  • Vaginal Atrophy: Thinning and drying of the vaginal walls due to decreased estrogen levels, often seen in postmenopausal women, leading to pain and burning during sex.
  • Urinary Tract Infection (UTI): Infections of the urinary tract can cause burning during urination and may also lead to discomfort during sex.

Do Not Miss Diagnoses

  • Pelvic Inflammatory Disease (PID): A serious infection of the female reproductive organs that can cause severe pain, burning, and other systemic symptoms. If missed, PID can lead to infertility, chronic pain, and other complications.
  • Endometriosis: A condition where tissue similar to the lining of the uterus grows outside the uterus, leading to pain, burning, and discomfort during sex. It's crucial to diagnose and treat endometriosis to prevent long-term consequences like infertility.
  • Cervical or Vaginal Cancer: Although rare, these cancers can cause pain and burning during sex. Early detection is critical for effective treatment and survival.

Rare Diagnoses

  • Lichen Sclerosus: A rare skin condition that can cause thinning and patchy skin in the genital area, leading to pain, burning, and discomfort during sex.
  • Lichen Planus: An autoimmune condition that can affect the skin and mucous membranes, including the vagina, causing pain, burning, and discomfort.
  • Vaginal Dermatitis: Inflammation of the vaginal skin due to allergic reactions or irritants, which can cause burning, itching, and pain during and after sex.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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